US counties by adult cigarette smoking rate, local model estimate
Oglala Lakota County had the highest adult cigarette smoking rate, local model estimate of 3068 counties in 2021, at 43%. Utah County had the lowest, at 6.6%. The median was 17.8%. Source: the Centers for Disease Control and Prevention.
Map of counties, 2021
Top 40 counties, 2021
Full ranking
Other periods
About this ranking
Percentage of adults who have smoked at least 100 cigarettes in their lifetime and now smoke every day or on some days. Model-based estimate for adults aged 18 and over from CDC PLACES. Crude prevalence, not age-adjusted.
US counties and cities (incorporated places of 10,000 or more). CDC PLACES combines Behavioral Risk Factor Surveillance System (BRFSS) answers with local population data through multilevel regression and poststratification, so a county or city value is a model estimate, not a survey count. The year is the BRFSS survey year, not the release year. CDC says the method does not support tracking change in a place over time, and each annual release can change the model, so values for different years are not strictly comparable. A state is missing in a year when its BRFSS data did not meet standards (Kentucky and Pennsylvania in 2023, Florida in 2021). Connecticut counties appear as its nine planning regions from 2022; its eight former counties are not served. City values for 2021 come from the 2023 release, built on 2010 Census place boundaries; later years use 2020 boundaries. State and national values come from direct BRFSS estimates under adult_smoking_rate.
Every value in the ranking comes from the same publisher and the same period, so the counties are compared on one definition. 76 counties with data in other periods have no value for 2021 and are left out rather than filled from another source. Equal values share a rank.
How to cite
Centers for Disease Control and Prevention (CDC). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. https://www.cdc.gov/places/. Retrieved 2026-10-12. These data are available free from CDC. Use does not imply endorsement by CDC, ATSDR, HHS or the United States Government.Citation styles
APA 7
Centers for Disease Control and Prevention. (2025). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence (US counties by adult cigarette smoking rate, local model estimate, 2021) [Data set]. Retrieved October 12, 2026, from https://www.cdc.gov/places/
MLA 9
PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence, US counties by adult cigarette smoking rate, local model estimate, 2021. Centers for Disease Control and Prevention, 4 Dec. 2025, https://www.cdc.gov/places/. Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/us-counties?period=2021. Accessed 12 Oct. 2026.
Chicago (author-date)
Centers for Disease Control and Prevention. 2025. PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. US counties by adult cigarette smoking rate, local model estimate, 2021. Dataset. Accessed October 12, 2026. https://www.cdc.gov/places/. Also distributed by Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/us-counties?period=2021.
Harvard
Centers for Disease Control and Prevention (2025) PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence, US counties by adult cigarette smoking rate, local model estimate, 2021 [Dataset]. Available at: https://www.cdc.gov/places/, via Invokely: https://invokely.ai/rankings/adult-smoking-rate-county-estimate/us-counties?period=2021 (Accessed: 12 October 2026).
BibTeX
@misc{centers_us_counties_by_adult_2021,
author = {{Centers for Disease Control and Prevention}},
title = {{PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence: US counties by adult cigarette smoking rate, local model estimate, 2021}},
year = {2025},
howpublished = {Data set},
url = {https://www.cdc.gov/places/},
urldate = {2026-10-12},
note = {Accessed via Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/us-counties?period=2021. Publisher attribution: Centers for Disease Control and Prevention (CDC). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. https://www.cdc.gov/places/. Retrieved 2026-10-12. These data are available free from CDC. Use does not imply endorsement by CDC, ATSDR, HHS or the United States Government.},
}
RIS
TY - DATA
AU - Centers for Disease Control and Prevention
TI - PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence: US counties by adult cigarette smoking rate, local model estimate, 2021
PY - 2025
DA - 2025/12/04
PB - Centers for Disease Control and Prevention
DB - Invokely
UR - https://www.cdc.gov/places/
L2 - https://invokely.ai/rankings/adult-smoking-rate-county-estimate/us-counties?period=2021
Y2 - 2026/10/12
N1 - Accessed via Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/us-counties?period=2021.
N1 - Publisher attribution: Centers for Disease Control and Prevention (CDC). PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. https://www.cdc.gov/places/. Retrieved 2026-10-12. These data are available free from CDC. Use does not imply endorsement by CDC, ATSDR, HHS or the United States Government.
ER -
Use this data in your AI agent
Invokely serves this figure to AI assistants through MCP and to code through a REST API, with the source and citation attached. Ask your assistant:
Rank US counties by adult cigarette smoking rate, local model estimate using official data, and cite the source.
rank_places {"indicator":"adult_smoking_rate_modelled","level":"province","within":"United States","limit":10}
GET https://invokely.ai/api/v1/rank?indicator=adult_smoking_rate_modelled&level=province&within=United%20States&limit=10Questions
Which county has the highest adult cigarette smoking rate, local model estimate?
Oglala Lakota County, with 43% in 2021, according to the Centers for Disease Control and Prevention.
Which county has the lowest adult cigarette smoking rate, local model estimate?
Utah County, with 6.6% in 2021.
Where does this ranking come from?
Every value comes from one source and one period, so the places are comparable: Centers for Disease Control and Prevention, PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. Retrieved 2026-10-12. 76 counties have no value for 2021 and are not ranked.
Adult cigarette smoking rate, local model estimate: other rankings
- Counties in California
- Counties in Florida
- Counties in Michigan
- Cities in Kentucky
- Cities in Montana
- Cities in Massachusetts