The study from health insurance comparison service iSelect was based on statistical modeling, price and tax data, and search behavior analysis.
According to the study, 13.2% of adults in North Carolina continued to smoke in 2025, a decline of just 0.98% from the previous year. 8.4% of adults use electronic cigarettes.
Per 10,000 people in North Carolina, there have been 10.48 online searches about quitting smoking, according to the study.
The study gave North Carolina a smoking health score of 34.77 out of 100.
Rounding out the top 10 worst states for smoking habits with North Carolina in the study were Tennessee with a score of 20.41, West Virginia with a score of 21.70, Louisiana with a score of 28.01, Oklahoma with a score of 30.10, Nevada with a score of 31.28, South Dakota with a score of 32.30, Missouri with a score of 32.72, Mississippi with a score of 32.92, and Alabama with a score of 33.09.
The healthiest state for smoking habits, according to the study, was Connecticut with a score of 70.79.
iSelect did not include Kentucky and Pennsylvania in the study, citing missing vaping data.
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