About 18.2% of the U.S. adult population smokes, down from over 40% half a century ago. 
 
 Despite the dramatic decline, smoking is the leading cause of preventable death in the United States. Each year, tobacco consumption kills nearly half a million Americans, and another 16 million are currently living with a disease caused by smoking. 
 
 Though no major U.S. metro area tops the nationwide smoking rate of 50 years ago, there are several cities where more than one in five adult residents report a smoking habit. 24/7 Wall St. reviewed Gallup poll data to identify the U.S. metro areas with the highest smoking rates. In a handful of cities, the smoking rate tops 25%. 
 
 Click here to see the cities where the most people smoke. 
 
 Click here to see the detailed findings and methodology. ||||| Source: Thinkstock 
 
 30. Springfield, MO 
 
 > Smoking rate: 23.0% 
 
 > Avg. price per pack in Missouri: $4.83 (5th lowest) 
 
 > Adults living with cancer diagnosis: 8.7% 
 
 > Adults who have had a heart attack: 4.6% 
 
 Source: Thinkstock 
 
 29. Lexington-Fayette, KY 
 
 > Smoking rate: 23.1% 
 
 > Avg. price per pack in Kentucky: $4.77 (4th lowest) 
 
 > Adults living with cancer diagnosis: 7.8% 
 
 > Adults who have had a heart attack: 2.8% 
 
 Source: Thinkstock 
 
 28. Columbia, SC 
 
 > Smoking rate: 23.1% 
 
 > Avg. price per pack in South Carolina: $4.97 (6th lowest) 
 
 > Adults living with cancer diagnosis: 7.1% 
 
 > Adults who have had a heart attack: 4.2% 
 
 Source: Thinkstock 
 
 27. Chattanooga, TN-GA 
 
 > Smoking rate: 23.2% 
 
 > Avg. price per pack in Georgia: $4.67 (3rd lowest) 
 
 > Adults living with cancer diagnosis: 9.2% 
 
 > Adults who have had a heart attack: 5.5% 
 
 Source: Thinkstock 
 
 26. Youngstown-Warren-Boardman, OH-PA 
 
 > Smoking rate: 23.2% 
 
 > Avg. price per pack in Ohio: $6.12 (24th highest) 
 
 > Adults living with cancer diagnosis: 7.3% 
 
 > Adults who have had a heart attack: 6.0%
– 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.