Iowa's tobacco use is relatively low. If tobacco were the primary problem (as indicated by the focus of the solution), you'd expect Iowa to use more tobacco than most or all states.

Given that their utilization is so low, it cannot possibly be the leading contributor.

Reducing an already low use of the product is a dumb place to start and a worse place to stop if your goal is to decrease the cancer rate.

If your goal were to reduce the cancer rate, you'd focus on something about your population that is contributing to the higher cancer rate.