As of 2023, the U.S. states with the highest smoking rates included West Virginia, Tennessee, and Louisiana. In West Virginia, around 20 percent of all adults smoked as of this time. The number of smokers in the United States has decreased over the past decades. Who smokes? The smoking rates for both men and women have decreased for many years, but men continue to smoke at higher rates than women. As of 2021, around 13 percent of men were smokers compared to 10 percent of women. Concerning race and ethnicity, smoking is least prevalent among Asians with just five percent of this population smoking compared to 13 percent of non-Hispanic whites. Health impacts of smoking The negative health impacts of smoking are vast. Smoking increases the risk of heart disease, stroke, and many different types of cancers. For example, smoking is estimated to be attributable to 81 percent of all deaths from lung cancer among adults 30 years and older in the United States. Smoking is currently the leading cause of preventable death in the United States.