– In the past 50 years, the US smoking rate has fallen from 40% to about 18%. That suggests the habit and the health problems associated with it are easing, yet more than a quarter of residents still smoke in some US cities. The US metropolitan areas (none of them major ones) with the highest smoking rates, per 24/7 Wall St.: Fort Smith, Ark.-Okla.: 28.3% Lafayette, La.: 28.3% Erie, Pa.: 28.2% Kingsport-Bristol-Bristol, Tenn.-Va.: 28% Fayetteville, NC: 27.8% Spartanburg, SC: 27.6% Canton-Massillon, Ohio: 27.5% Huntington-Ashland, W. Va.-Ky.-Ohio: 27.2% Hickory-Lenoir-Morganton, NC: 25.4% Winston-Salem, NC: 25% Click for the full list or see the US cities with the worst diets.