Cigarette sales climbed in the U.S. in 2020 for the first time in two decades. Americans bought a total of 203.7 billion cigarettes last year, up from 202.9 billion the year before, according to a Federal Trade Commision report. The uptick coincided with increased cigarette promotional and ad spending by tobacco companies.
Smoking claims nearly half a million American lives annually, according to the Centers for Disease Control and Prevention. Another 16 million Americans are living with a serious illness caused by smoking. Tobacco use also has an economic impact, including more than $225 billion spent each year on medical expenses to treat the smoking-related illness in the U.S. and over $156 billion in lost productivity.
Clinch County, home to the city of Homerville, has the highest smoking rate of any county or county equivalent in Georgia. An estimated 28.0% of the 18 and older population are smokers — meaning they smoke every day or most days and have smoked at least 100 cigarettes in their lifetime. The smoking rate across the state as a whole stands at 16.3%.
Smoking is the leading cause of preventable death in the United States, and places where large shares of the population are smokers often have lower than average life expectancy at birth. Clinch County is no exception. Life expectancy at birth in the county is an estimated 72.6 years, below the comparable 77.9 years across all of Georgia.
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All data on smoking rates, life expectancy, and self reported health status used in this story are from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute joint program’s 2021 County Health Rankings & Roadmaps report. Only counties and county equivalents with a 2019 five-year population estimate from the U.S. Census Bureau of 1,000 or more were considered.
| County with highest smoking rate by state | Adult smoking rate, county (%) | Adult smoking rate, state (%) | Life expectancy at birth, county (yrs.) | Life expectancy at birth, state (yrs.) | Adults in fair or poor health, county (%) | Adults in fair or poor health, state (%) |
|---|---|---|---|---|---|---|
| AK: Kusilvak Census Area | 44.6 | 18.5 | 67.2 | 79.0 | 41.9 | 15.6 |
| AL: Perry County | 27.3 | 20.0 | 72.3 | 75.6 | 34.6 | 21.4 |
| AR: Lee County | 28.9 | 23.7 | 74.6 | 76.1 | 33.6 | 23.3 |
| AZ: Apache County | 25.0 | 14.5 | 73.1 | 80.0 | 31.2 | 18.6 |
| CA: Del Norte County | 19.2 | 11.5 | 76.5 | 81.7 | 22.6 | 17.6 |
| CO: Crowley County | 23.7 | 14.7 | 79.2 | 80.6 | 23.8 | 13.8 |
| CT: Windham County | 16.4 | 12.5 | 78.5 | 80.9 | 15.5 | 13.0 |
| DE: Kent County | 19.7 | 17.4 | 77.8 | 78.5 | 21.0 | 16.3 |
| FL: Dixie County | 30.9 | 14.9 | 75.4 | 80.2 | 27.4 | 19.5 |
| GA: Clinch County | 28.0 | 16.3 | 72.6 | 77.9 | 30.9 | 18.4 |
| HI: Hawaii County | 18.7 | 14.4 | 80.6 | 82.3 | 17.1 | 15.4 |
| IA: Wayne County | 23.2 | 17.4 | 78.3 | 79.4 | 17.7 | 13.5 |
| ID: Shoshone County | 22.9 | 15.0 | 75.5 | 79.4 | 21.5 | 15.1 |
| IL: Alexander County | 27.0 | 15.9 | 73.5 | 79.4 | 26.0 | 15.9 |
| IN: LaGrange County | 29.2 | 21.7 | 78.9 | 77.1 | 23.1 | 18.2 |
| KS: Woodson County | 25.0 | 17.9 | 79.1 | 78.5 | 21.1 | 16.3 |
| KY: Clay County | 33.6 | 24.1 | 71.7 | 75.6 | 35.7 | 21.8 |
| LA: East Carroll Parish | 34.3 | 21.1 | 72.1 | 76.1 | 40.5 | 21.4 |
| MA: Bristol County | 19.5 | 13.7 | 78.7 | 80.6 | 16.1 | 13.5 |
| MD: Somerset County | 21.8 | 12.6 | 75.5 | 79.2 | 23.8 | 15.2 |
| ME: Somerset County | 25.8 | 19.4 | 76.5 | 78.7 | 20.0 | 17.1 |
| MI: Lake County | 29.1 | 20.1 | 76.9 | 78.1 | 25.7 | 18.3 |
| MN: Mahnomen County | 30.0 | 15.5 | 70.1 | 80.9 | 24.3 | 12.9 |
| MO: Wayne County | 30.7 | 20.1 | 74.9 | 77.3 | 26.9 | 19.5 |
| MS: Issaquena County | 31.1 | 21.0 | N/A | 74.9 | 37.4 | 22.1 |
| MT: Glacier County | 33.6 | 18.9 | 70.9 | 78.9 | 27.2 | 14.1 |
| NC: Robeson County | 30.0 | 17.9 | 72.8 | 78.1 | 31.2 | 18.0 |
| ND: Sioux County | 36.2 | 19.7 | 68.5 | 79.7 | 33.9 | 13.6 |
| NE: Thurston County | 27.1 | 16.6 | 69.5 | 79.6 | 23.5 | 13.8 |
| NH: Coos County | 19.8 | 16.6 | 77.3 | 79.7 | 18.5 | 12.8 |
| NJ: Cumberland County | 22.6 | 13.2 | 75.3 | 80.5 | 25.2 | 15.5 |
| NM: McKinley County | 27.6 | 15.9 | 71.9 | 78.0 | 31.3 | 20.3 |
| NV: Mineral County | 24.1 | 15.7 | 73.4 | 78.7 | 24.4 | 19.1 |
| NY: Herkimer County | 24.9 | 13.0 | 79.4 | 81.4 | 16.8 | 16.3 |
| OH: Vinton County | 31.3 | 21.4 | 74.5 | 77.0 | 24.2 | 17.8 |
| OK: Adair County | 32.1 | 19.9 | 73.2 | 76.1 | 33.4 | 20.9 |
| OR: Josephine County | 22.9 | 15.7 | 76.6 | 79.9 | 21.9 | 18.2 |
| PA: Forest County | 25.7 | 17.9 | 78.8 | 78.5 | 23.5 | 17.6 |
| RI: Kent County | 18.5 | 15.2 | 79.2 | 79.8 | 15.4 | 16.5 |
| SC: Dillon County | 26.7 | 18.7 | 72.9 | 77.1 | 29.9 | 17.8 |
| SD: Oglala Lakota County | 40.9 | 20.2 | 64.4 | 78.9 | 34.9 | 13.4 |
| TN: Lake County | 30.9 | 20.8 | 72.4 | 76.0 | 30.4 | 21.2 |
| TX: Hall County | 23.8 | 14.2 | 77.5 | 79.2 | 31.2 | 18.7 |
| UT: San Juan County | 18.8 | 9.1 | 76.4 | 80.1 | 25.4 | 14.8 |
| VA: Buchanan County | 29.1 | 15.1 | 74.0 | 79.6 | 28.0 | 16.6 |
| VT: Orleans County | 21.2 | 14.7 | 78.6 | 79.8 | 15.9 | 12.8 |
| WA: Ferry County | 21.7 | 12.1 | 77.7 | 80.4 | 22.3 | 15.0 |
| WI: Menominee County | 33.6 | 17.2 | 71.6 | 79.5 | 28.7 | 14.8 |
| WV: McDowell County | 34.7 | 26.9 | 69.0 | 74.8 | 36.5 | 23.6 |
| WY: Niobrara County | 22.8 | 19.2 | 80.2 | 78.9 | 19.5 | 15.3 |
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