Published: Thursday, 12 Nov 2009 | 1:41 PM ET

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Cigarette smoking rose slightly for the first time in almost 15 years, dashing health officials' hopes that the U.S. smoking rate had moved permanently below 20 percent.

A little under 21 percent of Americans were current cigarette smokers, according to a 2008 national survey by the U.S. Centers for Disease Control and Prevention. That's up slightly from the year before, when just 19.8 percent said they were smoking. It also is the first increase in adult smoking since 1994, experts noted.

Photo By: Camila Zanon Cigarettes

The increase was so small, it could be just a blip, so health officials and experts say smoking prevalence is flat, not rising. But they are unhappy.

"Clearly, we've hit a wall in reducing adult smoking," said Vince Willmore, spokesman for the Campaign for tobacco-Free Kids, a Washington, D.C.- based research and advocacy organization.

There's a general perception that smoking is a dying public health danger. Feeding that perception are indoor smoking laws, cigarette taxes and Congress's recent decision to allow the U.S. Food and Drug Administration to regulate tobacco.

But health officials believe gains have been undermined by cuts in state tobacco control campaigns. Also, the tobacco industry has been discounting cigarettes to offset tax increases and keep smokes affordable, Willmore said, citing tobacco industry sales data.

The adult smoking rate has been dropping, in starts and stops, since the mid-1960s when roughly 2 out of 5 U.S. adults smoked. Now it's 1 in 5. However, federal health goals for the year 2010 had hoped to bring the rate down to close to 1 in 10.

Adult smoking hovered at about 21 percent from 2004 to 2006, then dropped a full percentage point in 2007, said Dr. Matthew McKenna, director of the CDC's Office on Smoking and Health.

The 2007 drop gave CDC officials hope that U.S. smoking was plummeting again. "Now that appears to be a statistical aberration," McKenna said.

The new survey's results come from in-person interviews of nearly 22,000 U.S. adults.

The study was released Thursday, published in the CDC publication, Morbidity and Mortality Weekly Report.

Also on Thursday, the CDC released state-by-state results on smoking from a different survey, conducted by telephone, of more than 400,000 adults. West Virginia and Indiana had the highest smoking rates, at about 26 percent, but four other states—Kentucky, Missouri, Oklahoma and Tennessee—had rates about as high.

Utah had, by far, the lowest smoking rate, with only about 9 percent of Utah residents describing themselves as current smokers.

Many of the states that have the lowest smoking rates are those that have been the most aggressive about indoor smoking laws and about state taxes that drive up the cost of cigarettes, said Dr. Thomas Frieden, the CDC's director.

Health officials are optimistic that more and more smokers will be discouraged from lighting up by escalating cigarette taxes, including a 62-cent federal tax that took effect in April. Perhaps the recession will have an impact, too.

"In general, when people have less money, they smoke less," Frieden said. "Time will tell."

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