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.

22. Louisville/Jefferson County, KY-IN
> Smoking rate: 23.5%
> Avg. price per pack in Indiana: $5.40 (15th lowest)
> Adults living with cancer diagnosis: 7.2%
> Adults who have had a heart attack: 3.9%

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.