The Centers for Disease Control have released a study that ranks smoking rates and policies state-by-state … and it says Missouri needs to step up its efforts.

Click map to see a breakdown of Missouri's smoking statistics.

Click map to see a breakdown of Missouri's smoking statistics.

CDC Director Thomas Frieden says after decades of progress, the decline of smoking stopped about five years ago.

Frieden says about 46 million Americans smoke, leading to about a thousand deaths a day. Statewide indoor smoking bans, anti-smoking advertising and excise taxes have been successful in cutting the numbers in several states, but he says Missouri is not among them.

Missouri’s tobacco tax is the second lowest in the country, 17 cents. He says that rate was established nearly 20 years ago. (South Carolina brings up the bottom.)

Frieden says states that have upped their tax rate and have used the money gained to implement more anti-smoking advertising and more cessation programs have seen a return on that money by seeing the number of smokers drop.

One in four adults in our state smoke compared to the national average, which is less than one in five.

Missouri is also one of about half of the states that have not implemented indoor smoking bans.

States with the highest smoking rates include West Virginia with 26.5 percent, Indiana with 26 percent, Kentucky with 25.2 percent, Missouri with 25 percent and Oklahoma with 24.7 percent.

The lowest smoking states include Utah with 9.3 percent, California with 14 percent, New Jersey with 14.8 percent and Maryland with 14.9 percent.

Frieden says smoking causes more than 1,000 deaths every day, and that for every death, about 20 people suffer from smoking-related illnesses.

“Tobacco costs about $100 billion a year in medical expenses and lost productivity,” he says.

“After decades of progress, the decline stopped about five or six years ago,” Frieden adds. “We’ve seen an increase in smoking in youth in the 90s, then a steady decline in the early 2000s, and then a stall.”

The key, he says, is having all the states adopt uniform tobacco control plans.

“If states make the right decisions, if policymakers and families make the right decisions, we can save lives.”

The report concludes that putting uniform tobacco control policies in place would dramatically reduce the health and economic burden on states.

“The first step is knowledge, knowing what the issues are,” Frieden said. “We need to act.”

Jessica Machetta reports [Download / listen Mp3, 1:20 min.]

CDC Director Frieden discusses report [Download / listen Mp3, 38:43 min.]