HealthDay News — Cigarette smoking continues to decline in about half of American states, according to the latest U.S. government estimates. The new report was published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

But despite that good news, rates have gone up in some states. And in other states, a more worrisome trend has emerged — people using a combination of tobacco products, such as cigarettes plus smokeless tobacco, officials said.

Smoking declined across the nation from 21.2% of adults in 2011 to 19.0% in 2013, according to the report. Among states, however, vast differences in smoking rates exist, the researchers said. 

In fact, in 2013, rates varied from a low of 10.3% in Utah to a high of 27.3% in West Virginia. For smokeless tobacco, rates also varied widely in 2013. Only 1.5% of people used smokeless tobacco in the District of Columbia and Massachusetts, but 9.4% of people in West Virginia did, the researchers found.

From 2011 to 2013, cigarette smoking declined in 26 states. But smokeless tobacco use declined in only two states, Ohio and Tennessee. 

On the other hand, smokeless tobacco use increased in four states — Louisiana, Montana, South Carolina, and West Virginia. Moreover, the combined use of cigarettes and smokeless tobacco increased in five states — Delaware, Idaho, Nevada, New Mexico, and West Virginia.


1. CDC. MMWR. 2015; 64(19):532-536.