Sept. 7, 2010  -- Anti-smoking advocates worry they are losing the war on tobacco because cash-strapped states and communities are not spending enough to combat the cigarette industry.

The Centers for Disease Control and Prevention today released the results of a new survey that concludes adult smoking rates, which had been on the decline for three decades, have stopped going down over the past five years. The report finds nearly 47 million people, one out of every five adults, were smokers in 2009, a rate that has remained about the same since 2005.

"So why has the decline stalled? The answer really is quite simple," CDC Director Tom Frieden said today. "The tobacco industry combined with the failure of governments and communities to do what we know to reduce tobacco use."

Frieden said states spent $700 million last year on tobacco control. The tobacco industry spent $12 billion -- 35 times as much -- on the marketing and promotion of smoking.

"While government efforts are often standing still or even moving backward, the tobacco industry is not standing still," Frieden said.

The amount spent by states is just a small fraction, Frieden said, of the $25 billion they took in from tobacco taxes and cash from a 1998 settlement with cigarette manufacturers.

Richard Barnes, a researcher at the University of California's Center for Tobacco Research and Education, said "only a couple states really use" the tobacco money they take in for tobacco control. "Most of them spend it on prisons and roads and things like that." Compounding the problem, he said, the recession has eaten away at many state programs meant to fight smoking.

"The economy has had a very significant effect on state spending on their tobacco control programs," Barnes said. "It's just one of the first places that legislators pick because they have just not grasped the payback that a well-run program can have."

Smoking Rate Holds Steady; CDC Blames Tobacco Marketing

Frieden estimated that five million lives could be saved over the next five years if others followed the lead of states like California, which has imposed some of the nation's toughest smoking limits over the last 20 years. Smoking in California has dropped 40 percent and lung cancer rates are dropping four times faster in California than in the rest of the United States.

Barnes said California's investment has had a "huge bang for the buck – a 50-to-one return on investment" in the form of health care savings.

"It's just a staggering number, how much is saved if you have good smoking-education and smoking-cessation programs," Barnes said. "If policymakers just absorbed that information, I can't think of any other policy program that would have that kind of return on investment."

Smoking remains the top cause of preventable death in the United States, killing more than 1,000 people a day. Those who live and work with smokers also are at risk. The CDC reported today that 88 million non-smokers – including more than half of all children 3 to 11 years old -- are exposed to secondhand smoke. Virtually all children whose parents smoke have been exposed to the toxic chemicals in cigarette smoke.

"What's so striking, Frieden said, "is that virtually no kids who live with smokers actually are smoke-free when we test their blood."