Alabama ranks number 10 in the US of the percentage of adults who smoke. The national number has declined considerably, from about one-third of adults in 1980 to a quarter of adults in 1990 to fewer than 17% in the most recent surveys. 21.1% of adults in Alabama smoke. In 2014, nearly 17 of every 100 US adults aged 18 years or older smoked cigarettes. Cigarette smoking is the leading cause of preventable disease and death in the United States, accounting for more than 480,000 deaths every year.