Nearly half a million Americans annually die as a result of smoking, the leading cause of preventable death in the United States. Another 16 million Americans are living with a serious illness caused by smoking. Smoking also has an economic impact, including more than $225 billion each year spent on medical expenses to treat the smoking-related illness in the U.S. and over $156 billion in lost productivity.
Though the risks associated with smoking and tobacco use are well established and widely understood, 42.4 million American adults — or 16.6% of the adult population — smoke every day or most days and have smoked at least 100 cigarettes in their lifetime.
In Iowa, the smoking rate is higher than it is nationwide. An estimated 17.4% of the 18 and older population in Iowa are smokers, the 24th highest smoking rate among states.
States where large shares of the population smoke often have below average health outcomes, and vice versa — but Iowa is an exception in at least one key measure. Despite a relatively high smoking rate, average life expectancy at birth in the state is 79.4 years, slightly longer than the national average of 79.2 years.
All data used in this story is from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute joint program’s 2021 County Health Rankings & Roadmaps report.
RankStateAdults who smoke (%)Avg. life expectancy at birth (years)1West Virginia26.974.82Kentucky24.175.63Arkansas23.776.14Indiana21.777.15Ohio21.477.06Louisiana21.176.17Mississippi21.074.98Tennessee20.876.09South Dakota20.278.910Missouri20.177.311Michigan20.178.112Alabama20.075.613Oklahoma19.976.114North Dakota19.779.715Maine19.478.716Wyoming19.278.917Montana18.978.918South Carolina18.777.119Alaska18.579.020Pennsylvania17.978.521North Carolina17.978.122Kansas17.978.523Iowa17.479.424Delaware17.478.525Wisconsin17.279.526Nebraska16.679.627New Hampshire16.679.728Georgia16.377.929New Mexico15.978.030Illinois15.979.431Nevada15.778.732Oregon15.779.933Minnesota15.580.934Rhode Island15.279.835Virginia15.179.636Idaho15.079.437Florida14.980.238Colorado14.780.639Vermont14.779.840Arizona14.580.041Hawaii14.482.342Texas14.279.243Massachusetts13.780.644New Jersey13.280.545New York13.081.446Maryland12.679.247Connecticut12.580.948Washington12.180.449California11.581.750Utah9.180.1