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After declining for seven years, national smoking rates have remained steady at about 21 percent from 2004 to 2006, prompting concern among federal health officials that progress in curtailing smoking has stalled.

The national Centers for Disease Control and Prevention said reduced spending on anti-tobacco campaigns and bigger marketing budgets from cigarette companies appeared to be the reasons.

According to a CDC report released Thursday, funding for state tobacco control and prevention programs decreased about 20 percent from 2002 to 2006. Between 1998 and 2005, spending for tobacco-industry marketing nearly doubled from about $7 billion to $13 billion, according to the report.

“What is happening doesn’t have to happen,” said Dr. Matt McKenna, director of the CDC’s Office on Smoking and Health. “With appropriate support and efforts and countermarketing, tens of thousands of people don’t have to die.”

About 438,000 Americans die each year because of tobacco use, the CDC said. The agency estimated that for every death, there are 20 people living with a tobacco-related illness.

“Smoking is still the No. 1 preventable cause of death,” McKenna said.

U.S. smoking rates have been on a downward trend since a surgeon general’s report in 1964 linked lung cancer and cigarette smoking. At the time, about 42 percent of American adults were smokers, according to a study the next year.

Between 1997 to 2004 – the most recent period of consistent decline – the proportion of U.S. adults smokers dropped from 24.7 percent to 20.9 percent.

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