| West Virginia has the highest smoking rate in the nation, according to most studies.
Charleston and Huntington are at the top of a list of cities with the highest proportion of smokers, according to Healthways, a well-being company based in Tennessee.
A 2010 list is based on data from the Gallup-Healthways Well-Being Index.
West Virginia and the nation's smokers will soon have to look at graphic photos on cigarette packs that drive the message home about smokers health problems.
The success of the program is doubtful, since smoking is an addiction, and needs to be treated like an addiction.
Dr. Rahul Gupta, department chief of the Kanawha-Charleston Health Department said, "The question is why?" the smoking rate is so high.
"One point is, this state does not fund tobacco-cessation programs at the level recommended by [U.S. Centers for Disease Control and Prevention] and that has been a continuation over the years," he said.
Much of the tobacco settlement money was taken to fill holes in the state's budget.
"Whatever policies the state has in place are not working," Gupta said.
The CDC recommends that West Virginia spend about $27 million a year on tobacco-cessation programs, but the state allocates about $6 million.
No money from the 55-cent per pack state tax on cigarettes goes toward smoking-cessation programs.
The state Division of Tobacco Prevention offers a Quitline for people to call in, but cannot afford to hold classes or offer products and medications to help people quit smoking.
Smoking costs West Virginia about $690 million a year in medical expenses, according to the CDC.
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