North Dakota Ranks 11th Worst for Smoking—How Do Our Neighbors Compare?

It seems we as Americans are slowly kicking the habit—cigarettes, that is. Every year, fewer people are lighting up, and more are putting out their last smoke for good. Still, every state has its fair share of puffers, and according to a recent study by iSelect, some states are making better progress than others. So, how does our neck of the woods measure up? Let’s break it down.

North Dakota
The Peace Garden State might not be at the bottom of the list, but we're not winning any medals either. Coming in as the 11th worst in the nation, North Dakota has a smoking rate of 13.3% in 2025, with a small but positive change of -1.22% compared to earlier years. On the bright side, folks are making progress—but at only 44 cents per pack in state taxes, it’s a little easier to see why cigarettes are still hanging around. With 9.3% e-cigarette use and an overall smoking health score of 35.22, North Dakota has a bit of work to do.

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South Dakota
Our southern neighbors aren’t faring much better. In fact, they’re doing worse. South Dakota landed as the 6th worst state in the nation with a smoking health score of 32.30. Yikes! Maybe they’re just too polite to say no when someone offers them a light.

Montana
Heading west, things are looking brighter. Montana is sitting pretty with a score of 43.84, showing that Big Sky Country is making healthier strides than its Dakota counterparts.

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Minnesota
Finally, we tip our caps to Minnesota, the regional leader in this race. With an impressive smoking health score of 46.58, the Land of 10,000 Lakes proves it’s possible to enjoy fresh air without filling it with smoke.

The iSelect study looked at smoking prevalence, e-cigarette use, taxes per pack, and even Google searches about quitting. The results highlight where Americans are winning the battle against smoking—and where there’s still room to clear the air.