Data / Rankings / Adult cigarette smoking rate, local model estimate / US counties

US counties by adult cigarette smoking rate, local model estimate

Kusilvak Census Area had the highest adult cigarette smoking rate, local model estimate of 3144 counties in 2022, at 38.2%. Utah County had the lowest, at 5.3%. The median was 17%. Source: the Centers for Disease Control and Prevention.

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Highest38.2Kusilvak Census Area
Lowest5.3Utah County
Median173144 counties

Map of counties, 2022

%, 2022. Source: CDC, PLACES: Local Data for Better Health, County Data (swc5-untb, fu4u-a9bh, h3ej-a9ec and later releases), adult cigarette smoking rate, crude prevalence. Boundaries: U.S. Census Bureau cartographic boundary files.

Top 40 counties, 2022

Kusilvak Census Area: 38.2 %Kusilvak Census Area38.2Oglala Lakota County: 37.3 %Oglala Lakota County37.3Sioux County: 36.5 %Sioux County36.5Buffalo County: 34.4 %Buffalo County34.4Bethel Census Area: 33.3 %Bethel Census Area33.3Nome Census Area: 33.3 %Nome Census Area33.3Todd County: 33.3 %Todd County33.3Hancock County: 30.6 %Hancock County30.6McKinley County: 30.6 %McKinley County30.6Wolfe County: 30.4 %Wolfe County30.4Glacier County: 29.9 %Glacier County29.9Lee County: 29.7 %Lee County29.7Ziebach County: 29.6 %Ziebach County29.6Northwest Arctic Borough: 29.2 %Northwest Arctic Borough29.2Martin County: 29.1 %Martin County29.1Jackson County: 28.6 %Jackson County28.6Rolette County: 28.3 %Rolette County28.3Mississippi County: 28.2 %Mississippi County28.2Yukon-Koyukuk Census Area: 28.2 %Yukon-Koyukuk Census Area28.2Roosevelt County: 28.1 %Roosevelt County28.1East Carroll Parish: 27.9 %East Carroll Parish27.9Dillingham Census Area: 27.7 %Dillingham Census Area27.7Magoffin County: 27.7 %Magoffin County27.7Dillon County: 27.4 %Dillon County27.4McDowell County: 27.4 %McDowell County27.4Dewey County: 27.3 %Dewey County27.3Claiborne Parish: 27.2 %Claiborne Parish27.2Harlan County: 27.2 %Harlan County27.2Wyoming County: 27.2 %Wyoming County27.2Clay County: 27 %Clay County27Lake County: 27 %Lake County27Mellette County: 27 %Mellette County27Corson County: 26.9 %Corson County26.9Ozark County: 26.9 %Ozark County26.9Lincoln County: 26.5 %Lincoln County26.5Ritchie County: 26.5 %Ritchie County26.5Mingo County: 26.4 %Mingo County26.4Apache County: 26.3 %Apache County26.3Tensas Parish: 26.3 %Tensas Parish26.3Casey County: 26.1 %Casey County26.1Kusilvak Census Area: 38.2 %Kusilvak Census Area38.2Oglala Lakota County: 37.3 %Oglala Lakota County37.3Sioux County: 36.5 %Sioux County36.5Buffalo County: 34.4 %Buffalo County34.4Bethel Census Area: 33.3 %Bethel Census Area33.3Nome Census Area: 33.3 %Nome Census Area33.3Todd County: 33.3 %Todd County33.3Hancock County: 30.6 %Hancock County30.6McKinley County: 30.6 %McKinley County30.6Wolfe County: 30.4 %Wolfe County30.4Glacier County: 29.9 %Glacier County29.9Lee County: 29.7 %Lee County29.7Ziebach County: 29.6 %Ziebach County29.6Northwest Arctic Borough: 29.2 %Northwest Arctic Borough29.2Martin County: 29.1 %Martin County29.1Jackson County: 28.6 %Jackson County28.6Rolette County: 28.3 %Rolette County28.3Mississippi County: 28.2 %Mississippi County28.2Yukon-Koyukuk Census Area: 28.2 %Yukon-Koyukuk Census Area28.2Roosevelt County: 28.1 %Roosevelt County28.1East Carroll Parish: 27.9 %East Carroll Parish27.9Dillingham Census Area: 27.7 %Dillingham Census Area27.7Magoffin County: 27.7 %Magoffin County27.7Dillon County: 27.4 %Dillon County27.4McDowell County: 27.4 %McDowell County27.4Dewey County: 27.3 %Dewey County27.3Claiborne Parish: 27.2 %Claiborne Parish27.2Harlan County: 27.2 %Harlan County27.2Wyoming County: 27.2 %Wyoming County27.2Clay County: 27 %Clay County27Lake County: 27 %Lake County27Mellette County: 27 %Mellette County27Corson County: 26.9 %Corson County26.9Ozark County: 26.9 %Ozark County26.9Lincoln County: 26.5 %Lincoln County26.5Ritchie County: 26.5 %Ritchie County26.5Mingo County: 26.4 %Mingo County26.4Apache County: 26.3 %Apache County26.3Tensas Parish: 26.3 %Tensas Parish26.3Casey County: 26.1 %Casey County26.1
%. Source: CDC, 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.

Full ranking

RankCounties2022 (%)Change on 2021
1Kusilvak Census Area38.2-4.6 pts
2Oglala Lakota County37.3-5.7 pts
3Sioux County36.5+1.7 pts
4Buffalo County34.4-0.4 pts
5Bethel Census Area33.3-2.2 pts
5Nome Census Area33.3+2.1 pts
5Todd County33.3-9.7 pts
8Hancock County30.6+1.2 pts
8McKinley County30.6+3.6 pts
10Wolfe County30.4-3.5 pts
11Glacier County29.9+1.4 pts
12Lee County29.7-2.1 pts
13Ziebach County29.6-2.6 pts
14Northwest Arctic Borough29.2-2.2 pts
15Martin County29.1+2.3 pts
16Jackson County28.6-2.3 pts
17Rolette County28.3-1.7 pts
18Mississippi County28.2+0.2 pts
18Yukon-Koyukuk Census Area28.2-1 pts
20Roosevelt County28.10 pts
21East Carroll Parish27.9-6.9 pts
22Dillingham Census Area27.7-1.4 pts
22Magoffin County27.7-2.6 pts
24Dillon County27.4+2.1 pts
24McDowell County27.4-2.6 pts
26Dewey County27.3-3.7 pts
27Claiborne Parish27.2-1.3 pts
27Harlan County27.2-4 pts
27Wyoming County27.2+1.2 pts
30Clay County27-4.8 pts
30Lake County27-2.3 pts
30Mellette County27-6.5 pts
33Corson County26.9-3 pts
33Ozark County26.9+1.1 pts
35Lincoln County26.5+0.2 pts
35Ritchie County26.5+2.5 pts
37Mingo County26.4-1.3 pts
38Apache County26.3-0.1 pts
38Tensas Parish26.3-0.2 pts
40Casey County26.1-2 pts
40Jackson County26.1-3.5 pts
40Kenedy County26.1+8.7 pts
43Bennett County26-1.3 pts
43Breckinridge County26+1.8 pts
43Grainger County26+1.8 pts
43Vinton County26-1.1 pts
47Fulton County25.9+0.6 pts
47McCreary County25.9-5.5 pts
47Menominee County25.9+1.2 pts
47Poinsett County25.9+1.1 pts
47Scott County25.9-2 pts
52Lewis County25.8-5 pts
53Evangeline Parish25.7-2.2 pts
53Holmes County25.70 pts
53Johnson County25.7-0.6 pts
53Lee County25.7-1.7 pts
53Lewis County25.7+0.4 pts
53Macon County25.7+1.5 pts
53Warren County25.7+1.1 pts
60Audrain County25.6+2 pts
60Bledsoe County25.6-1 pts
60Russell County25.6+1.2 pts
60St. Francis County25.6-0.8 pts
60Wirt County25.6+2 pts
65Calhoun County25.5-0.8 pts
65DeKalb County25.5+1.5 pts
65Lauderdale County25.5-1.4 pts
68Decatur County25.4+1.9 pts
68Madison Parish25.4-3 pts
68Wayne County25.4+0.3 pts
71Bienville Parish25.3-0.7 pts
71Estill County25.3-3.2 pts
71Hocking County25.3+1.7 pts
71Knott County25.3-2.8 pts
71Rhea County25.3+2.5 pts
76Benson County25.2-0.3 pts
76Buchanan County25.2+0.3 pts
76Desha County25.2-0.6 pts
76McDonald County25.2-1.9 pts
76Rockcastle County25.2-1 pts
81Fayette County25.1+2.4 pts
81Fulton County25.1+0.6 pts
81Green County25.1-0.7 pts
81Pickett County25.1+1.4 pts
81Wayne County25.1-0.5 pts
86Clay County25-0.7 pts
86Marlboro County25-1.7 pts
88Bell County24.9-5.1 pts
88Clark County24.9+1.3 pts
88Roane County24.9-0.4 pts
88Sequatchie County24.9-0.2 pts
92Adair County24.8-4.8 pts
92Haywood County24.8-0.6 pts
92Humphreys County24.8-2.1 pts
92Morgan County24.8-1.5 pts
92Pemiscot County24.8-2.3 pts
92Pocahontas County24.8+0.8 pts
92Ripley County24.8-2.8 pts
99Howell County24.7-0.6 pts
99Logan County24.7-1 pts
99Meigs County24.7-1.9 pts
99Stoddard County24.7-0.4 pts
103Bullock County24.6-0.9 pts
103Lafayette County24.6-0.6 pts
103Leflore County24.6+0.8 pts
103Owsley County24.6-4 pts
103Reynolds County24.6+0.4 pts
108Fayette County24.5+0.6 pts
108Morehouse Parish24.5-1.6 pts
108San Juan County24.5+3.2 pts
111Barton County24.4+0.4 pts
111Crawford County24.4-0.1 pts
111Fentress County24.4-0.6 pts
111Knox County24.4+0.7 pts
111Mahnomen County24.4-3.6 pts
111Menifee County24.4-2.6 pts
111Oregon County24.4-3.3 pts
111St. Mary Parish24.4+0.7 pts
111Wheeler County24.4-0.6 pts
120Clay County24.3-1.8 pts
120Hart County24.3-2.1 pts
120Humphreys County24.3+2.2 pts
120Liberty County24.3+3 pts
120Shannon County24.3-0.2 pts
120Unicoi County24.3+2 pts
126New Madrid County24.2-1.3 pts
126Robeson County24.2-1.4 pts
126Searcy County24.2-0.5 pts
129Adams County24.10 pts
129Avoyelles Parish24.1-2.8 pts
129Bollinger County24.1-0.3 pts
129Cocke County24.1-1.1 pts
129Guernsey County24.1+1.1 pts
129Marshall County24.1+1.2 pts
129Mississippi County24.1-0.4 pts
129Pike County24.1-2.3 pts
129White County24.1-0.3 pts
138Breathitt County24-3.7 pts
138Coffee County24+2.9 pts
138Dyer County24+2.2 pts
138Hardeman County24-1.4 pts
138Hardin County24+2.8 pts
138Jackson County24-0.9 pts
138Tunica County24-1 pts
145Lake and Peninsula Borough23.9-2.2 pts
145Maries County23.9+2.2 pts
145Morgan County23.9-3.2 pts
145Upshur County23.9+1.6 pts
145Webster Parish23.9-2.2 pts
150Boone County23.8-0.1 pts
150Newton County23.8+0.3 pts
150Sharkey County23.8+1.2 pts
150West Carroll Parish23.8-0.7 pts
154Calhoun County23.7-0.6 pts
154Franklin Parish23.7-3.1 pts
154Grant Parish23.70 pts
154Hampshire County23.7+1.3 pts
154Jackson County23.7-0.7 pts
154Morrow County23.7+2.6 pts
154Okfuskee County23.7-3.6 pts
154Randolph County23.7-0.9 pts
162Johnson County23.6-1.9 pts
162Larue County23.6+1 pts
162Phillips County23.6-1.2 pts
162Pike County23.6-2.9 pts
162Taylor County23.6+2.4 pts
162Van Buren County23.6+0.8 pts
162Wilcox County23.6-0.3 pts
162Yazoo County23.6-1.3 pts
170Chester County23.5+0.5 pts
170Dunklin County23.5-2.3 pts
170Leslie County23.5-5.1 pts
170North Slope Borough23.5-1.5 pts
170Ross County23.5+0.7 pts
175Big Horn County23.4-2.7 pts
175Carroll County23.4+1.9 pts
175Concordia Parish23.4-4.9 pts
175Fayette County23.4-0.4 pts
175Fleming County23.4-0.2 pts
175Franklin County23.4-1.2 pts
175Hickory County23.4+0.3 pts
175Monroe County23.4-0.8 pts
175Perry County23.4+0.7 pts
175Webster County23.4-1.9 pts
185Adams County23.3+1.7 pts
185Conway County23.3+1.4 pts
185Hardy County23.3+1.1 pts
185Holmes County23.3-2.3 pts
185Knox County23.3-5.7 pts
185Laclede County23.3+0.6 pts
185Neshoba County23.3-1.5 pts
185Washington County23.3-2.3 pts
193Carroll County23.2+1.6 pts
193Cedar County23.2-0.3 pts
193Coahoma County23.2-1.3 pts
193Craig County23.2-0.4 pts
193Dent County23.2-0.9 pts
193Grundy County23.2-1.5 pts
193Highland County23.2-0.7 pts
193Lincoln County23.2-0.7 pts
193Monroe County23.2+0.2 pts
193Red River Parish23.2-0.6 pts
203Cumberland County23.1-3 pts
203Daviess County23.1+2.1 pts
203Johnson County23.1-0.5 pts
203McCurtain County23.1-1 pts
203Metcalfe County23.1-1.3 pts
203Noble County23.1+0.7 pts
203Polk County23.1+2 pts
203Todd County23.1-1 pts
203Union County23.1+1.2 pts
212Caldwell Parish23-3.3 pts
212Claiborne County23-0.7 pts
212Cleveland County23+1.4 pts
212Jenkins County23-1.9 pts
212Lawrence County23+0.5 pts
212Linn County23+2 pts
212Robertson County23-0.5 pts
212Scott County23-1.2 pts
212Trumbull County23+1.6 pts
212Wright County23-2.9 pts
222Barbour County22.90 pts
222Carter County22.9+0.4 pts
222Cibola County22.9+0.8 pts
222Dade County22.9-1 pts
222Elliott County22.9-4.7 pts
222Henry County22.9-0.3 pts
222Le Flore County22.9-0.8 pts
222Lee County22.9+1 pts
222Martin County22.9+2.7 pts
222Miller County22.9+0.4 pts
222Overton County22.9-1.9 pts
222Perry County22.9-1.2 pts
222Quitman County22.9-3.7 pts
222St. Bernard Parish22.9-0.8 pts
222Thurston County22.9-1.2 pts
222Van Buren County22.9-3.3 pts
238Braxton County22.8-2.7 pts
238Coal County22.8-0.9 pts
238Crawford County22.8+0.9 pts
238Lawrence County22.8-0.7 pts
238Lyman County22.8+0.3 pts
238Preston County22.8+1.2 pts
238Randolph County22.8-0.9 pts
238Richland Parish22.8-3.4 pts
246Carter County22.7-0.9 pts
246Chicot County22.7-2.9 pts
246Dallas County22.7-2.3 pts
246Hickman County22.7-1.5 pts
246Jackson Parish22.7-0.2 pts

Showing the top 250 of 3144. The Excel download has every row.

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. 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

The publisher is the author. Invokely is named only as the place the figures were read, where a style asks for it.

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, 2022) [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, 2022. 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=2022. 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, 2022. 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=2022.

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, 2022 [Dataset]. Available at: https://www.cdc.gov/places/, via Invokely: https://invokely.ai/rankings/adult-smoking-rate-county-estimate/us-counties?period=2022 (Accessed: 12 October 2026).

BibTeX
@misc{centers_us_counties_by_adult_2022,
  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, 2022}},
  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=2022. 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, 2022
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=2022
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/us-counties?period=2022.
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  -
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Questions

Which county has the highest adult cigarette smoking rate, local model estimate?

Kusilvak Census Area, with 38.2% in 2022, according to the Centers for Disease Control and Prevention.

Which county has the lowest adult cigarette smoking rate, local model estimate?

Utah County, with 5.3% in 2022.

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.

Adult cigarette smoking rate, local model estimate: other rankings

US counties: more rankings