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Per CDC's 2019 Behavioral Risk Factor Surveillance System (explained in the article below), West Virginia had the highest rate of smoking in the country, at 23.8 %, followed by Kentucky, Louisiana, Ohio, Mississippi, Alabama, Arkansas, Tennessee, Missouri, Indiana, Oklahoma, and Michigan.
1 2 "The "Deeming Rule": Vape Shops" (PDF)
In fiscal year 2024, the states will collect $25.9 billion from the tobacco settlement and taxes, but they will spend just 2.8% of it $728.6 million on tobacco prevention and cessation programs for people of all ages, less than a quarter of what the CDC recommends
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