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The next four highest ranking states when it comes to prevalence are Kentucky (21.40%), Arkansas (20.50%), Mississippi (20.10%), and Tennessee (19.50%) these four states have achieved lower rates of smoking compared to West Virginia despite lower smoking costs relative to income and, with the exception of Arkansas, less expensive cigarettes

In fact, the majority of deaths caused by secondhand smoke are from heart disease and stroke, deaths which can be prevented by policies that protect non-smokers

Thun et al