The states that struggle the most with smoking

The power of nicotine addiction remains strong, as about one fifth of Americans continue to smoke. According to the CDC, smoking rates across the U.S. have declined about 3 percent since 2005, but millions continue to light up despite programs and regulations that encourage smokers to quit.

Smoking rates remain highest in West Virginia and Kentucky, at about 27 percent and 26 percent of the state populations. The Midwest and Southeast are close behind at 23 and 22 percent, respectively.

Utah had the lowest smoking rate at about 10 percent and California was a close second at less than 13 percent. The regions with the lowest smoking rates are the West and much of coastal New England.

More people are addicted to nicotine in the U.S. than any other drug, according the 2010-2011 National Health Interview Survey for Adult Smokers. The intensity of the addiction is on par with heroin, cocaine and alcohol, making it a very difficult habit to break.

Overall, about 45 percent of smokers have attempted to quit, but less than 3 percent were successful. Quitting smoking becomes more difficult with age, according to the survey, which monitors success rates by identifying factors including age, race, income, gender and education. By race, the survey shows that Hispanic smokers are significantly more successful at quitting than others, and American Indians are least likely to quit. Those with lower income and education levels are also less likely to quit smoking.

Though the picture is slow to change among adults, the CDC has reported a significant decline in regular smoking among teenagers, down almost half between 1991 and 2013, to about 14 percent.