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

Buchanan County had the highest adult cigarette smoking rate, local model estimate of 133 counties in 2022, at 25.2%. Falls Church city had the lowest, at 7.6%. The median was 16.1%. Source: the Centers for Disease Control and Prevention.

Highest25.2Buchanan County
Median16.1133 counties

Top 40 counties, 2022

Buchanan County: 25.2 %Buchanan County25.2Smyth County: 22.2 %Smyth County22.2Hopewell city: 22 %Hopewell city22Richmond County: 22 %Richmond County22Grayson County: 21.8 %Grayson County21.8Russell County: 21.8 %Russell County21.8Danville city: 20.9 %Danville city20.9Henry County: 20.8 %Henry County20.8Nottoway County: 20.8 %Nottoway County20.8Buckingham County: 20.7 %Buckingham County20.7Emporia city: 20.7 %Emporia city20.7Wise County: 20.6 %Wise County20.6Norton city: 20.5 %Norton city20.5Charlotte County: 20.4 %Charlotte County20.4Galax city: 20.3 %Galax city20.3Martinsville city: 20.3 %Martinsville city20.3Dickenson County: 20.2 %Dickenson County20.2Lee County: 20.2 %Lee County20.2Lunenburg County: 20.2 %Lunenburg County20.2Greensville County: 20.1 %Greensville County20.1Pittsylvania County: 20.1 %Pittsylvania County20.1Carroll County: 20 %Carroll County20Brunswick County: 19.9 %Brunswick County19.9Essex County: 19.5 %Essex County19.5Scott County: 19.5 %Scott County19.5Buena Vista city: 19.4 %Buena Vista city19.4King and Queen County: 19.3 %King and Queen County19.3Craig County: 19.2 %Craig County19.2Accomack County: 19.1 %Accomack County19.1Bath County: 19.1 %Bath County19.1Appomattox County: 18.8 %Appomattox County18.8Tazewell County: 18.7 %Tazewell County18.7Halifax County: 18.6 %Halifax County18.6Page County: 18.4 %Page County18.4Roanoke city: 18.4 %Roanoke city18.4Dinwiddie County: 18.3 %Dinwiddie County18.3Westmoreland County: 18.3 %Westmoreland County18.3Amelia County: 18.2 %Amelia County18.2Bristol city: 18.1 %Bristol city18.1Warren County: 18.1 %Warren County18.1
%. 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
1Buchanan County25.2+0.3 pts
2Smyth County22.2+1.6 pts
3Hopewell city22-0.1 pts
3Richmond County22+2 pts
5Grayson County21.8+1.2 pts
5Russell County21.8+1.2 pts
7Danville city20.9+0.2 pts
8Henry County20.8+0.2 pts
8Nottoway County20.8-0.1 pts
10Buckingham County20.7-1.5 pts
10Emporia city20.7-2.9 pts
12Wise County20.6-0.2 pts
13Norton city20.5-0.4 pts
14Charlotte County20.4+0.5 pts
15Galax city20.30 pts
15Martinsville city20.3-0.2 pts
17Dickenson County20.2-2.9 pts
17Lee County20.2-3.6 pts
17Lunenburg County20.2-1.1 pts
20Greensville County20.1-1.9 pts
20Pittsylvania County20.1+1.2 pts
22Carroll County20+0.5 pts
23Brunswick County19.9-0.7 pts
24Essex County19.5-0.1 pts
24Scott County19.5-1.4 pts
26Buena Vista city19.4-0.3 pts
27King and Queen County19.3+2 pts
28Craig County19.2+2.1 pts
29Accomack County19.1+0.5 pts
29Bath County19.1-1 pts
31Appomattox County18.8+0.7 pts
32Tazewell County18.7-1.2 pts
33Halifax County18.6-0.5 pts
34Page County18.4-0.9 pts
34Roanoke city18.4-1.4 pts
36Dinwiddie County18.3+0.1 pts
36Westmoreland County18.3-0.5 pts
38Amelia County18.2-0.2 pts
39Bristol city18.1-1.1 pts
39Warren County18.1+1.4 pts
41Sussex County17.9-2 pts
42Alleghany County17.8+0.1 pts
42Campbell County17.8+0.3 pts
42Franklin city17.8-1.9 pts
42Patrick County17.8+0.3 pts
46Covington city17.7-3 pts
46Petersburg city17.7-2.3 pts
48Prince George County17.4+0.4 pts
49Charles City County17.3-1.5 pts
50King William County17.2+1.1 pts
50Shenandoah County17.2+0.2 pts
52Giles County17-1 pts
52Portsmouth city17-1 pts
54Washington County16.9-0.1 pts
55Culpeper County16.8+0.9 pts
55Mecklenburg County16.8-1.2 pts
57Waynesboro city16.7-1.2 pts
58Amherst County16.6-0.6 pts
58Caroline County16.6-0.3 pts
58Cumberland County16.6+0.4 pts
58Rockbridge County16.6+1.1 pts
62Pulaski County16.5-1.1 pts
62Rappahannock County16.5+2.7 pts
64Richmond city16.4+0.4 pts
65Bland County16.3-2.1 pts
66Prince Edward County16.2-0.4 pts
67Fluvanna County16.1+3 pts
68Orange County16+0.2 pts
69Staunton city15.9-0.1 pts
69Surry County15.9-1.9 pts
71Greene County15.7+0.3 pts
72Augusta County15.6-1.2 pts
73Gloucester County15.5-0.1 pts
73Manassas Park city15.5+0.8 pts
75Norfolk city15.4-0.9 pts
76Franklin County15.3-1.3 pts
76Newport News city15.3-2.2 pts
78Botetourt County15.2+0.4 pts
78Chesapeake city15.2+1 pts
78Northampton County15.2-0.6 pts
78Winchester city15.2+0.1 pts
82Colonial Heights city15+0.1 pts
82Frederick County15-0.3 pts
84Floyd County14.9-1.9 pts
84Fredericksburg city14.9+2.1 pts
84Louisa County14.9-2.1 pts
84Madison County14.9-1.6 pts
84Nelson County14.9-0.8 pts
89King George County14.7+0.4 pts
89Middlesex County14.7-0.4 pts
91Wythe County14.6-3.9 pts
92Hampton city14.5-2.4 pts
92Isle of Wight County14.5-0.5 pts
92Rockingham County14.5-0.9 pts
95Charlottesville city14.4+1 pts
96Southampton County14.3-2.1 pts
97Lancaster County14.2+0.1 pts
97Spotsylvania County14.2+0.6 pts
99Hanover County14.1+1.8 pts
99Harrisonburg city14.1-1.4 pts
101Bedford County13.8-0.7 pts
101Northumberland County13.8-0.4 pts
103Suffolk city13.7-1.5 pts
104Mathews County13.6+0.2 pts
105Clarke County13.1-0.3 pts
105Roanoke County13.1-0.4 pts
107Radford city12.9-3.1 pts
107Salem city12.9-1.5 pts
109Fauquier County12.70 pts
110Montgomery County12.6-0.9 pts
110New Kent County12.6-1.3 pts
110Powhatan County12.6-1.4 pts
113Henrico County12.4-0.8 pts
113Stafford County12.4+0.4 pts
115Manassas city12.2-1.3 pts
116Prince William County12.1+0.2 pts
117Lynchburg city12-2.4 pts
118Chesterfield County11.6-1.5 pts
118Virginia Beach city11.6-1.9 pts
120Highland County11.4-4.4 pts
120York County11.4+0.4 pts
122Goochland County11.3-0.4 pts
123Fairfax city11.2+1.1 pts
123Poquoson city11.2-1.1 pts
125Williamsburg city11.1-0.1 pts
126James City County10.6-0.2 pts
127Albemarle County10-0.3 pts
128Arlington County9.7+1.5 pts
129Loudoun County9.3+0.3 pts
130Alexandria city9.2-1.1 pts
130Lexington city9.2-1.8 pts
132Fairfax County8.2-0.1 pts
133Falls Church city7.60 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, 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, Counties in Virginia 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/virginia-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. Counties in Virginia 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/virginia-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, Counties in Virginia 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/virginia-counties?period=2022 (Accessed: 12 October 2026).

BibTeX
@misc{centers_counties_in_virginia_by_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: Counties in Virginia 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/virginia-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: Counties in Virginia 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/virginia-counties?period=2022
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/adult-smoking-rate-county-estimate/virginia-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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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 25.2% in 2022, 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 7.6% 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

Counties in Virginia: more rankings