I consistently get 18 doing mostly city driving. It's all about anticipating stops, and getting to cruising speeds efficiently. This DOES NOT mean slowly. There is a common misconception that accelerating as slowly as possibly saves fuel. Plugging in a Scangauge immediately proves that theory wrong. Ideally, you want to accelerate moderately, and get to a "cruising" or low-throttle state as soon as possible. That may be 30 mph for 3 blocks until the next stop.
Think of it this way: Accelerating slowly for 10 seconds you'll see your fuel efficiency (FE) start at about 5mpg and reach about 17mpg by the time you've hit 30mph. That's an average FE of 11mpg, assuming you accelerate at a steady rate. Now accelerate moderately, so it takes you 5 seconds to reach 30mph. You'll see you start at about 5mpg, and end at 17mpg, but once you've reached 30mph, you can release the throttle significantly...reaching FE's in the 30's. Your average just jumped by several MsPG. I've tested this, and it works.
Also, delete your roof rack if you don't use it. It's not much, but it does increase the overall drag coefficient of your truck. I went a step further and removed the "deflector" off the back door as well...which really only acted as an air brake.