Counties in Virginia by adult cigarette smoking rate, local model estimate, 2023

Buchanan County had the highest adult cigarette smoking rate, local model estimate of 133 counties in 2023, at 21.6%. Falls Church city had the lowest, at 6.7%. The median was 14.5%. Source: the Centers for Disease Control and Prevention.

Highest21.6Buchanan County
Median14.5133 counties

Top 40 counties, 2023

Buchanan County: 21.6 %Buchanan County21.6Lee County: 21.2 %Lee County21.2Dickenson County: 20.6 %Dickenson County20.6Hopewell city: 20.3 %Hopewell city20.3Covington city: 19.9 %Covington city19.9Grayson County: 19.8 %Grayson County19.8Norton city: 19.8 %Norton city19.8Wise County: 19.4 %Wise County19.4Bath County: 19.3 %Bath County19.3Charlotte County: 19.2 %Charlotte County19.2Galax city: 19.2 %Galax city19.2Greensville County: 19.2 %Greensville County19.2Danville city: 19.1 %Danville city19.1Martinsville city: 19.1 %Martinsville city19.1Russell County: 19 %Russell County19Lunenburg County: 18.9 %Lunenburg County18.9Emporia city: 18.6 %Emporia city18.6Scott County: 18.6 %Scott County18.6Buckingham County: 18.4 %Buckingham County18.4Halifax County: 18.4 %Halifax County18.4Smyth County: 18.3 %Smyth County18.3Pittsylvania County: 18.1 %Pittsylvania County18.1Tazewell County: 18.1 %Tazewell County18.1Nottoway County: 18 %Nottoway County18Brunswick County: 17.9 %Brunswick County17.9Carroll County: 17.9 %Carroll County17.9Henry County: 17.8 %Henry County17.8Amelia County: 17.7 %Amelia County17.7Richmond County: 17.3 %Richmond County17.3Bristol city: 17.2 %Bristol city17.2Patrick County: 17.2 %Patrick County17.2Sussex County: 17.1 %Sussex County17.1Westmoreland County: 17.1 %Westmoreland County17.1Page County: 17 %Page County17Essex County: 16.9 %Essex County16.9Petersburg city: 16.9 %Petersburg city16.9Franklin city: 16.8 %Franklin city16.8Wythe County: 16.7 %Wythe County16.7Alleghany County: 16.6 %Alleghany County16.6Charles City County: 16.6 %Charles City County16.6
%. 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

RankCounties2023 (%)Change on 2022
1Buchanan County21.6-3.6 pts
2Lee County21.2+1 pts
3Dickenson County20.6+0.4 pts
4Hopewell city20.3-1.7 pts
5Covington city19.9+2.2 pts
6Grayson County19.8-2 pts
6Norton city19.8-0.7 pts
8Wise County19.4-1.2 pts
9Bath County19.3+0.2 pts
10Charlotte County19.2-1.2 pts
10Galax city19.2-1.1 pts
10Greensville County19.2-0.9 pts
13Danville city19.1-1.8 pts
13Martinsville city19.1-1.2 pts
15Russell County19-2.8 pts
16Lunenburg County18.9-1.3 pts
17Emporia city18.6-2.1 pts
17Scott County18.6-0.9 pts
19Buckingham County18.4-2.3 pts
19Halifax County18.4-0.2 pts
21Smyth County18.3-3.9 pts
22Pittsylvania County18.1-2 pts
22Tazewell County18.1-0.6 pts
24Nottoway County18-2.8 pts
25Brunswick County17.9-2 pts
25Carroll County17.9-2.1 pts
27Henry County17.8-3 pts
28Amelia County17.7-0.5 pts
29Richmond County17.3-4.7 pts
30Bristol city17.2-0.9 pts
30Patrick County17.2-0.6 pts
32Sussex County17.1-0.8 pts
32Westmoreland County17.1-1.2 pts
34Page County17-1.4 pts
35Essex County16.9-2.6 pts
35Petersburg city16.9-0.8 pts
37Franklin city16.8-1 pts
38Wythe County16.7+2.1 pts
39Alleghany County16.6-1.2 pts
39Charles City County16.6-0.7 pts
41Accomack County16.5-2.6 pts
41Roanoke city16.5-1.9 pts
43King and Queen County16.4-2.9 pts
43Portsmouth city16.4-0.6 pts
45Mecklenburg County16.3-0.5 pts
46Bland County16-0.3 pts
46Giles County16-1 pts
48Shenandoah County15.9-1.3 pts
49Appomattox County15.8-3 pts
49Buena Vista city15.8-3.6 pts
51Pulaski County15.7-0.8 pts
52Amherst County15.6-1 pts
52Craig County15.6-3.6 pts
54Winchester city15.5+0.3 pts
55Cumberland County15.4-1.2 pts
56Campbell County15.3-2.5 pts
57Caroline County15.2-1.4 pts
57Waynesboro city15.2-1.5 pts
59Floyd County15+0.1 pts
59Franklin County15-0.3 pts
59Southampton County15+0.7 pts
59Warren County15-3.1 pts
63Louisa County14.90 pts
64Washington County14.8-2.1 pts
65Dinwiddie County14.6-3.7 pts
65Prince Edward County14.6-1.6 pts
67Augusta County14.5-1.1 pts
68Northampton County14.4-0.8 pts
68Surry County14.4-1.5 pts
70Greene County14.2-1.5 pts
70Richmond city14.2-2.2 pts
72Hampton city14.1-0.4 pts
72Madison County14.1-0.8 pts
72Newport News city14.1-1.2 pts
75Radford city14+1.1 pts
76Rockingham County13.9-0.6 pts
77King William County13.8-3.4 pts
77Manassas Park city13.8-1.7 pts
77Prince George County13.8-3.6 pts
77Rockbridge County13.8-2.8 pts
81Culpeper County13.7-3.1 pts
81Nelson County13.7-1.2 pts
81Norfolk city13.7-1.7 pts
81Orange County13.7-2.3 pts
85Gloucester County13.5-2 pts
85Rappahannock County13.5-3 pts
85Staunton city13.5-2.4 pts
88Lancaster County13.4-0.8 pts
89Bedford County13.2-0.6 pts
89Harrisonburg city13.2-0.9 pts
89Isle of Wight County13.2-1.3 pts
89Suffolk city13.2-0.5 pts
93King George County13.1-1.6 pts
93Mathews County13.1-0.5 pts
93Middlesex County13.1-1.6 pts
96Botetourt County13-2.2 pts
96Frederick County13-2 pts
96Salem city13+0.1 pts
99Colonial Heights city12.8-2.2 pts
99Highland County12.8+1.4 pts
99Powhatan County12.8+0.2 pts
99Spotsylvania County12.8-1.4 pts
103Chesapeake city12.5-2.7 pts
103Fluvanna County12.5-3.6 pts
105Lynchburg city12.3+0.3 pts
105New Kent County12.3-0.3 pts
107Manassas city12-0.2 pts
107Northumberland County12-1.8 pts
109Roanoke County11.9-1.2 pts
109Virginia Beach city11.9+0.3 pts
111Hanover County11.8-2.3 pts
111Montgomery County11.8-0.8 pts
113Clarke County11.7-1.4 pts
113Fredericksburg city11.7-3.2 pts
115Chesterfield County11.5-0.1 pts
115Fauquier County11.5-1.2 pts
117Henrico County11.4-1 pts
118Poquoson city11.20 pts
119Charlottesville city11.1-3.3 pts
119Prince William County11.1-1 pts
121Stafford County11-1.4 pts
122Goochland County10.1-1.2 pts
123York County10-1.4 pts
124James City County9.7-0.9 pts
124Williamsburg city9.7-1.4 pts
126Fairfax city9.2-2 pts
126Lexington city9.20 pts
128Albemarle County9-1 pts
128Alexandria city9-0.2 pts
130Loudoun County8.4-0.9 pts
131Fairfax County8.1-0.1 pts
132Arlington County7-2.7 pts
133Falls Church city6.7-0.9 pts

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 (Counties in Virginia by adult cigarette smoking rate, local model estimate, 2023) [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, Counties in Virginia by adult cigarette smoking rate, local model estimate, 2023. Centers for Disease Control and Prevention, 4 Dec. 2025, https://www.cdc.gov/places/. Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/virginia-counties. 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. Counties in Virginia by adult cigarette smoking rate, local model estimate, 2023. Dataset. Accessed October 12, 2026. https://www.cdc.gov/places/. Also distributed by Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/virginia-counties.

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, Counties in Virginia by adult cigarette smoking rate, local model estimate, 2023 [Dataset]. Available at: https://www.cdc.gov/places/, via Invokely: https://invokely.ai/rankings/adult-smoking-rate-county-estimate/virginia-counties (Accessed: 12 October 2026).

BibTeX
@misc{centers_counties_in_virginia_by_2023,
  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: Counties in Virginia by adult cigarette smoking rate, local model estimate, 2023}},
  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/virginia-counties. 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: Counties in Virginia by adult cigarette smoking rate, local model estimate, 2023
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/virginia-counties
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/virginia-counties.
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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Rank Counties in Virginia by adult cigarette smoking rate, local model estimate using official data, and cite the source.
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Questions

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

Buchanan County, with 21.6% in 2023, according to the Centers for Disease Control and Prevention.

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

Falls Church city, with 6.7% in 2023.

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

Counties in Virginia: more rankings