Some say it's a crisis; rich people no longer smoke, but the poor and the less educated still do. Tobacco critics say that disparity has huge health implications.
Smoking rights expert and radio host Gary Nolan says everyone knows smoking is unhealthy.
"There's constant, free information about smoking cessation; I don't care what socioeconomic class you fall into, people see this information. These people are perhaps so poor this is the only recreation they have."
Nolan worries the path to totalitarianism could begin with health care.
If we eventually wind up with a single payer health system the government will start banning things it finds unhealthy, like smoking, overeating, drinking, et cetera.
"They're not just going to go after people who smoke but people who are obese, people who don't get enough exercise. You can see where everything you do that doesn't lead to good health outcomes you could be compelled by government to quit or change."
The Centers for Disease Control says for those with a high-school-equivalency diploma the smoking rate remains more than 40 percent. Rural residents are diagnosed with lung cancer at rates 18 to 20% above those of city dwellers.