However, the government says many states still have yet to commit spending for smoking prevention. Only six out the 46 states that participated in the billion-dollar anti-smoking settlement with the tobacco industry have spent money on prevention.
While aggressive anti-smoking campaigns appear to be working in states such as Oregon and California, smoking rates actually rose in states with few controls such as tobacco-producing Kentucky.
"Smoking is a communicable disease," said Dr. Jeffrey Koplan of the Centers for Disease Control and Prevention, referring to the sophisticated marketing used by the tobacco industry. "We have the vaccine; we have a spectrum of activities and regulations that have been shown to work. We're just frittering away our resources."
Kentucky had the highest adult smoking rate in the nation in 1997 at 30.8 percent, up from 27.8 percent in 1995. Kentucky's youth smoking rate also is the highest in the country, with 47 percent of students in grades nine through 12 saying they had smoked in the previous month.
Utah, with its large Mormon population, had the lowest adult rate at 13.7 percent and the lowest youth rate at 16.4 percent. That state has had the lowest rate in each of the last three reports issued by the CDC.
In states where excise taxes have gone up and anti-smoking campaigns have been implemented, rates have steadily declined.
California had the second-lowest adult rate at 18.4 percent in 1997 after hitting 26 percent in 1984, a drop attributed to the nation's oldest anti-smoking initiative, which began in 1989.
"They had a very varied and multi-ethnic population ... but they had the foresight to provide the resources for an aggressive tobacco control campaign, and it worked," Koplan said.
Oregon's cigarette consumption rate decreased 11.3 percent between 1996 and 1998 after voters there approved a similar program in 1996.
And Massachusetts voters approved higher tobacco taxes and an aggressive anti-smoking media campaign in 1993, and the state's consumption rate dropped 20 percent between 1992 and 1996.
Hawaii, Maryland, Minnesota, New Jersey, Vermont and Washington have made public education commitments in line with CDC recommendations, according to a report issued Tuesday by the Campaign for Tobacco-Free Kids, a Washington D.C. advocacy group, and the American Heart Association.
Other states have either made no decision at all or made the funds available for tax cuts, prison construction, college scholarships and other programs.
The report suggests states should spend between $31 million and $83 million on health and anti-smoking programs.