The average smoking rate in the United States has declined significantly over the past several decades. That’s the good news. The bad news is that a group of 12 contiguous states in the Deep South and Midwest is lagging behind.
Referred to as “Tobacco Nation” in a new report from the Truth Initiative, an anti-smoking group, the region consists of Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Tennessee and West Virginia. In those states, 22% of adults smoke, compared with 15% in the rest of the United States giving the area the highest concentration of smokers in the nation.
“We think of the United States as being the most technologically advanced, richest nation in the world, with access to some of the best science and health care,” said Robin Koval, president of the Washington-based Truth Initiative. “Yet when you look at what we call Tobacco Nation, it looks more like a part of the developing world than it looks like the United States of America.”
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Smoking rates in the 12-state region have declined over time, though at a slower pace than in the rest of the country. That’s had consequences for public health. Tobacco-related conditions including lung and other cancers, heart disease and chronic lower respiratory ailments are more prevalent in those states, according to the report.
The states, which account for about 20% of the U.S. population, are poorer and less educated than the rest of the nation. The have lower excise taxes on average and fewer laws that prevent smokers from lighting up in workplaces, restaurants and bars. In addition to supporting such taxes and laws, the Truth Initiative calls for raising the minimum age for purchasing cigarettes to 21.