IT TAKES A LOT OF EFFORT TO KEEP YOURSELF POOR AND ILL IN AMERICA:

[A]s evidence of smoking's deadly consequences has accumulated, the broad patterns of use by class have shifted: Smoking, the leading cause of preventable death in the country, is now increasingly a habit of the poor and the working class.

While previous data established that pattern, a new analysis of federal smoking data released on Monday shows that the disparity is increasing. The national smoking rate has declined steadily, but there is a deep geographic divide. In the affluent suburbs of Washington, only about one in 10 people smoke, according to the analysis, by the Institute for Health Metrics and Evaluation. But in impoverished places like this -- Clay County, in eastern Kentucky -- nearly four in 10 do.

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