The good news: The U.S. smoking rate is the lowest in 45 years.

The bad news: The rate has stagnated at nearly 21 percent for the last five years after four decades of decline. And smoking remains the top cause of preventable deaths, with an estimated 450,000 Americans dying from smoking-related diseases every year.

Thanks to a mix of cultural mores, state government spending on smoking-prevention programs, and creative efforts by the tobacco industry, tens of millions of Americans still light up every day—and in some places more than others. The Daily Beast wanted to find out exactly which cities have the biggest smoking problem. Specifically, which American cities not only smoke the most, but also try to quit the least?

To figure out which cities have the worst smoking problem, we considered which locales had the largest population of smokers, where the smokers smoked the most cigarettes per day, and had made the fewest attempts to quit. For reliable consumer-behavior data, Experian Simmons provided data for more than 60 urban centers with populations of more than 1 million.

The number of adults who smoke per capita and the average number of cigarettes smoked per day by self-described smokers were each weighted one-third of the total score. The final third of the ranking was devoted to considering the percentage of adults who attempted to quit in the last year with counseling, a nicotine patch or nicotine gum. The cities whose citizens have made the smallest attempt to quit smoking were penalized.

Midwestern and Southern states scored the worst—demographics that tied into the education levels, race, and income levels of the residents. But few parts of the country were immune.

#1, Tulsa, Oklahoma Smokers: 24.6% Cigarettes per day: 16.2 Tried to quit with gum: 26.9% Tried to quit with patch: 32.8% Tried to quit with support program: 7.4%

#2, Wilkes Barre-Scranton, Pennsylvania Smokers: 23.5% Cigarettes per day: 16.8 Tried to quit with gum: 25.8% Tried to quit with patch: 27.6% Tried to quit with support program: 9.3%

#3, Memphis, Tennessee Smokers: 22.5% Cigarettes per day: 14.3 Tried to quit with gum: 21.7% Tried to quit with patch: 27.5% Tried to quit with support program: 5.4%

#4, Indianapolis, Indiana Smokers: 23.8% Cigarettes per day: 15.5 Tried to quit with gum: 26.9% Tried to quit with patch: 25.8% Tried to quit with support program: 9%

#5, Louisville, Kentucky Smokers: 25.4% Cigarettes per day: 16.2 Tried to quit with gum: 31.9% Tried to quit with patch: 35.6% Tried to quit with support program: 9%

#6, St. Louis, Missouri Smokers: 22.8% Cigarettes per day: 14.5 Tried to quit with gum: 24.1% Tried to quit with patch: 25% Tried to quit with support program: 8.7%

#7, Oklahoma City, Oklahoma Smokers: 22.1% Cigarettes per day: 15.4 Tried to quit with gum: 23.5% Tried to quit with patch: 30.4% Tried to quit with support program: 8.9%

#8, Birmingham, Alabama Smokers: 21.7% Cigarettes per day: 14.6 Tried to quit with gum: 23.5% Tried to quit with patch: 26.8% Tried to quit with support program: 8.2%

#9, Grand Rapids, Michigan Smokers: 21.6% Cigarettes per day: 14.5 Tried to quit with gum: 25.5% Tried to quit with patch: 25% Tried to quit with support program: 8.4%

#10, Las Vegas, Nevada Smokers: 22.8% Cigarettes per day: 14.2 Tried to quit with gum: 29.9% Tried to quit with patch: 28.2% Tried to quit with support program: 8.6%

#11, Little Rock, Arkansas Smokers: 20.3% Cigarettes per day: 15.9 Tried to quit with gum: 25.5% Tried to quit with patch: 30.8% Tried to quit with support program: 9.1%

#12, Knoxville, Tennessee Smokers: 21.5% Cigarettes per day: 16.7 Tried to quit with gum: 25.4% Tried to quit with patch: 35.1% Tried to quit with support program: 11.1%

#13, Honolulu, Hawaii Smokers: 18.2% Cigarettes per day: 15 Tried to quit with gum: 39.3% Tried to quit with patch: 20.2% Tried to quit with support program: 3.8%

#14, Pittsburgh, Pennsylvania Smokers: 19.2% Cigarettes per day: 16.2 Tried to quit with gum: 26% Tried to quit with patch: 25.7% Tried to quit with support program: 10.1%

#15, Nashville, Tennessee Smokers: 21.1% Cigarettes per day: 15.6 Tried to quit with gum: 26.2% Tried to quit with patch: 32.7% Tried to quit with support program: 9.5%

#16, Mobile, Alabama Smokers: 19.1% Cigarettes per day: 14.6 Tried to quit with gum: 26.4% Tried to quit with patch: 29% Tried to quit with support program: 6.4%

#17, San Antonio, Texas Smokers: 18.9% Cigarettes per day: 12.5 Tried to quit with gum: 21.6% Tried to quit with patch: 25.9% Tried to quit with support program: 5.3%

#18, Cincinnati, Ohio Smokers: 19.6% Cigarettes per day: 15.5 Tried to quit with gum: 26.5% Tried to quit with patch: 28.7% Tried to quit with support program: 9.4%

#19, Tampa, Florida Smokers: 19.7% Cigarettes per day: 14.9 Tried to quit with gum: 26.5% Tried to quit with patch: 31.5% Tried to quit with support program: 7.7%

#20, Jacksonville, Florida Smokers: 19.7% Cigarettes per day: 14.4 Tried to quit with gum: 26.8% Tried to quit with patch: 27.5% Tried to quit with support program: 8%

#21, Charlotte, North Carolina Smokers: 19.1% Cigarettes per day: 15.1 Tried to quit with gum: 26.4% Tried to quit with patch: 29% Tried to quit with support program: 8.5%

#22, Columbus, Ohio Smokers: 20.3% Cigarettes per day: 15.9 Tried to quit with gum: 33.4% Tried to quit with patch: 32.4% Tried to quit with support program: 8.3%

#23, Greensboro, North Carolina Smokers: 20.8% Cigarettes per day: 15.1 Tried to quit with gum: 29.3% Tried to quit with patch: 28.9% Tried to quit with support program: 10%

#24, New Orleans, Louisiana Smokers: 19.9% Cigarettes per day: 14.3 Tried to quit with gum: 25.9% Tried to quit with patch: 34.2% Tried to quit with support program: 6.9%

#25, Kansas City, MO-KS Smokers: 19.7% Cigarettes per day: 14.5 Tried to quit with gum: 26% Tried to quit with patch: 27% Tried to quit with support program: 9%

#26, Raleigh-Durham, North Carolina Smokers: 19.5% Cigarettes per day: 13.8 Tried to quit with gum: 28.4% Tried to quit with patch: 26.3% Tried to quit with support program: 7.2%

#27, Richmond, Virginia Smokers: 17.9% Cigarettes per day: 14.4 Tried to quit with gum: 29.1% Tried to quit with patch: 25.7% Tried to quit with support program: 6.2%

#28, Greenville, South Carolina Smokers: 19.8% Cigarettes per day: 15.9 Tried to quit with gum: 29.7% Tried to quit with patch: 28.2% Tried to quit with support program: 10.5%

#29, Milwaukee, Wisconsin Smokers: 18.5% Cigarettes per day: 14.2 Tried to quit with gum: 26.7% Tried to quit with patch: 21.8% Tried to quit with support program: 8.9%

#30, Albany, New York Smokers: 19.9% Cigarettes per day: 15.3 Tried to quit with gum: 30.1% Tried to quit with patch: 28.5% Tried to quit with support program: 9.8%