Background: Cigarette smoking is the leading preventable cause of death in the United States. Aim: To estimate the prevalence of and recent trends in smoking among adults residing in three types of rural locations. Methods: Telephone survey of adults aged 18 years or older who participated in the Behavioral Risk Factor Surveillance System in 1994-1996 and 2000-2001. Results: The prevalence of smoking changed little from the mid-1990s; it was 22.0% in urban areas, 24.9% in rural adjacent areas, 24.0% in large rural non-adjacent areas, and 24.9% in small rural non-adjacent areas. For rural locations combined, its prevalence was not below the 12% goal of HealthyPeople 2010 for any state. Its prevalence was ≥ 28% for rural residents of Kentucky, Ohio and Indiana. Since the mid-1990s, the prevalence of smoking for rural respondents decreased by more than 2% in California, Connecticut, Maryland, North Carolina, Tennessee, and Utah. However, it increased by 2% or more in Alabama, Delaware, Georgia, Massachusetts, Michigan, Mississippi, New Hampshire, Oklahoma, South Carolina, and Texas. Conclusions: Smoking remains a refractory public health problem. Better ways to curb smoking in rural America are needed. Funded by HRSA’s ORHP.