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Adult smoking rates relatively low in North Dakota, Minnesota

FARGO – North Dakota and Minnesota rank among the states with relatively low percentages of adult smokers, but smoking rates vary widely among counties, according to a new comparison of counties.

In North Dakota, 18 percent of adults smoke, and the smoking rate ranges from 8 percent in Hettinger County to 44 percent in Sioux County, which makes up a portion of the Standing Rock Indian Reservation in North Dakota.

In Minnesota, 16 percent of adults smoke, ranging from 7 percent in Nicollet County to 35 percent in Mahnomen County, which includes part of the White Earth Indian Reservation.

The rankings, released Tuesday, were compiled by the Robert Wood Johnson Foundation’s County Health Rankings & Roadmaps program and based on federal behavioral risk surveys from 2006 to 2012.

“Counties can look at this and understand what’s driving tobacco use in their communities,” said Karen Odegaard, an associate researcher at the University of Wisconsin’s Population Health Institute, a partner in the project.

Armed with a better understanding of the factors that contribute to a county’s health profile can enable communities to devise strategies to improve their health status, she said.

Nationally, the percentage of adult smokers has declined in recent years, from 21 percent in 2005 to 18 percent in 2012, the most recent figure available.

Poorer counties have found it more difficult to decrease tobacco use, according to a new study published in the journal “Population Health Metrics.”

That might help to explain why adult smoking rates are much higher in counties with Indian reservations.

Sioux County, N.D., with an adult smoking rate of 44 percent, ranked among the 20 counties with the highest rates of male smokers, according to the national study. Rolette County, where the Turtle Mountain Indian Reservation is located, had an adult smoking rate of 36 percent, the next highest.

In Fargo-Moorhead, neighboring Cass County, N.D., and Clay County, Minn., both were below the national average: In Cass County, 16 percent of adults smoked, compared to 17 percent in Clay County.

Elsewhere in North Dakota, the adult smoking rates for selected counties:

Burleigh, 13 percent; Grand Forks, 15 percent; Ransom, 14 percent; Richland, 19 percent; Stark, 19 percent; Stutsman, 17 percent and Traill, 13 percent.

In Minnesota, the adult smoking rates for selected counties:

Becker, Hubbard, Ottertail, all 17 percent; Norman, 19 percent.

States and communities can take steps to create an environment that discourages smoking and encourages cessation and prevention, Odegaard said.

The County Rankings & Roadmap website offers programs and policies that can reduce smoking.

Indoor smoking bans, such as the one North Dakota voters adopted statewide, can help to discourage smoking, she said.

Tobacco taxes also can help reduce smoking rates. Last year, Minnesota raised its tobacco tax to $2.83 a pack, moving the state from 28th in the country to seventh.

“Where we live matters to our health,” Odegaard said.


Patrick Springer

Patrick Springer first joined the reporting staff of The Forum in 1985. He can be reached by calling 701-241-5522. Have a comment to share about a story? Letters to the editor should include author’s name, address and phone number. Generally, letters should be no longer than 250 words. All letters are subject to editing. Send to

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