Key findings:

  • Smoking habits leave one in three young adults at severe risk of COVID-19 illness.
  • Smoking is associated with doubling the risk of COVID-19 progression.
  • COVID-19 hospitalizations among young adults have increased by nearly 300% from April to June.
  • The 17% prevalence in smoking among Americans is a higher rate than many other high-risk conditions such as asthma, COPD and diabetes.
  • West Virginia, Kentucky and Arkansas are among the states with the highest smoking rates in the country.
  • Smoking prevalence has decreased by 15% since 2012.

Smoking trends reveal new COVID-19 risk

Early on in the COVID-19 pandemic, the CDC indicated people over the age of 65 and those with pre-existing conditions like asthma, chronic obstructive pulmonary disease (COPD) and diabetes are most at risk of serious illness from COVID-19. While those groups of people remain at risk, there was a common misunderstanding that younger people were at little risk of serious illness from the virus. As states began to reopen after shutdown orders, many young people flocked to bars and restaurants with little recourse of their exposure to the virus. The recent spikes in COVID-19 cases across the country are being attributed to young adults being the primary spreaders of the virus. An increase in cases and hospitalizations among young adults has changed the conversation about how vulnerable young adults actually are against COVID-19 illness. Hospitalizations among young adults have seen a nearly-300% increase from April to June compared to a 139% increase in hospitalizations among older adults.

With young adults seeing a significant increase in hospitalizations, there is a renewed risk for the age group. Recent studies from the University of California San Francisco (UCSF) have found smoking to be a primary risk factor among younger adults for serious illness from COVID-19. The UCSF study found that one in three young adults faces severe illness from COVID-19. The study focused on the prevalence of smoking among young adults compared to other risk factors such as asthma, COPD and obesity. Young adults have typically lower rates of high-risk health conditions compared to older adults; however, the prevalence of smoking among young adults is higher than the prevalence of high-risk health conditions. The higher prevalence of smoking compared to other health conditions among young adults presents the highest risk factor for serious illness from COVID-19.

A second study from UCSF found that smoking was associated with nearly double the rate of COVID-19 progression, citing that pulmonary effects from smoking lead to more severe progression and illness from COVID-19. To see where smokers might be at the highest risk of serious illness from COVID-19, we here at QuoteWizard analyzed CDC smoking prevalence data from 2018 to see which states had the highest rates of smokers. Many of the states with the highest rates of smokers are also states that have seen significant spikes in new cases of COVID-19. Among those states with high rates of smokers and COVID-19 cases are Louisiana, Mississippi and Tennessee. While smoking has decreased by 15% nationwide since 2012, it’s still among the highest-risk group of people for serious COVID-19 illness. While we’re seeing young adults contracting COVID-19 at higher rates in recent months, it’s the young adult smokers who face the highest risk from the virus.

Smoking prevalence in each state

QuoteWizard analyzed CDC BRFSS Prevalence & Trends Data from 2018 to see which states had the highest rates of smokers. To get rankings to evaluate age-adjusted prevalence of current smokers in each state. Prevalence is an estimation of the smoking population in each state. Rankings are based on states with the highest prevalence of smokers to those with the lowest prevalence.

Rank State Prevalence
1 West Virginia 26.8
2 Kentucky 24.2
3 Arkansas 23.7
4 Indiana 21.5
5 Ohio 21.2
6 Mississippi 20.8
7 Louisiana 20.8
8 Tennessee 20.8
9 Missouri 20.1
10 Oklahoma 20
11 South Dakota 19.9
12 Michigan 19.8
13 Alabama 19.8
14 North Dakota 19.6
15 Wyoming 19.4
16 Maine 19.2
17 Alaska 19
18 Montana 18.8
19 South Carolina 18.6
20 North Carolina 17.8
21 Kansas 17.7
22 Pennsylvania 17.7
23 Iowa 17.3
24 Delaware 17.2
25 Wisconsin 16.8
26 New Hampshire 16.7
27 Nebraska 16.4
28 Georgia 16.3
29 Oregon 16.1
30 Nevada 16
31 Illinois 15.8
32 Minnesota 15.6
33 New Mexico 15.5
34 Idaho 15.1
35 Rhode Island 15.1
36 Virginia 15.1
37 Florida 15
38 Colorado 14.7
39 Arizona 14.4
40 Vermont 14.3
41 Texas 14.3
42 Hawaii 14.1
43 Massachusetts 13.7
44 New Jersey 13.3
45 New York 13.1
46 Maryland 12.7
47 Connecticut 12.6
48 Washington 12.2
49 California 11.4
50 Utah 9