THE Grampians is the smoking capital of Australia.
For the first time, National Health Performance Authority statistics have compared smoking rates in local areas across Australia.
The statistics don't make good reading for the Grampians region, which has an adult daily smoking rate of 28 per cent - far above the national rate of 16 per cent.
The Grampians Medicare Local area takes in Ararat, Stawell, Horsham, Nhill, Edenhope, Warracknabeal and Dimboola.
Medicare Local Grampians chief executive officer Andrew McPherson said it was difficult to say why the message of the dangers of smoking were not cutting through.
He said areas with a low socio-economic status tended to smoke at higher rates than communities that were 'better off and better educated'.
"That certainly applies in the Grampians," he said.
"As a community we need to work better together to reduce smoking rates."
While it was unknown until now that the region had such heavy smokers, Mr McPherson said there were some signs the region was struggling to kick the habit.
He said the Grampians had the highest rates of chronic obstructive pulmonary disease in the country.
"We weren't sure what all the factors were that were causing that but clearly a high smoking rate contributes," he said.
Ballarat Health Services head of medical oncology Kate Hamilton agreed pockets of socio-economic disadvantage played a part, as did an ageing population.
She said the anti-smoking campaigns run by the government were not having a strong enough effect in the region.
"Clearly with rates of 28 per cent the government needs to look at its campaigns," she said.
"We need to look at where smoking is still allowed and where we can reduce the number of public smoking places."