Progress in the effort to reduce smoking, seen as the leading cause of preventable death, has stalled since 2005 despite aggressive and expensive campaigns, a government report said Thursday.
In 2008, 20.6 percent of American adults smoked, amounting to 46 million people, virtually unchanged from the rate of 20.9 percent four years earlier, the Center for Disease Control and Prevention (CDC) said.
The "alarming" data based on a 2008 survey of 21,781 adults "hints that smoking rates may be moving in the wrong direction," the CDC said in its report.
Smoking has a massive impact on US society. The CDC says tobacco use kills more than 443,000 people each year and costs the country some 96 billion dollars in health care costs annually.
"Today tobacco will kill more than 1,000 people, but we can reduce smoking rates," said CDC Director Thomas Frieden.
"We must protect people from second-hand smoke, increase the price of tobacco, and support aggressive anti-tobacco campaigns that will reduce smoking and save lives."
"If every state had smoking rates similar to places which have implemented effective programs, there would be at least 10 million fewer smokers in the US, and millions of heart attacks, cancers, strokes and deaths would be prevented in decades to come."
The CDC said that from 1998 to 2008 the proportion of US smokers shrank from 24.1 percent to 20.6 percent, but that most of the decline occurred prior to 2005.
The latest figures are in stark relief to the federal funding that has been thrown into the effort to curb smoking.
Over the past decade US states have received more than 200 billion dollars in funding, from money supplied by tobacco companies forced to pay compensation in court cases, said Matthew McKenna, director of CDC's Office on Smoking and Health.
Of the 50 US states, only 21 plus the capital city Washington have implemented smoking bans in the workplace, restaurants and bars.