Death rates from smoking have fallen in every state except Oklahoma since the late 1990s, according to new figures from the U.S. Centers for Disease Control and Prevention.

In fact, smoking-death rates rose by 27 deaths in the Sooner State — to 332 deaths per 100,000 adults ages 35 or older, the CDC said in its latest Morbidity and Mortality Weekly Report.

"This report is a good reminder about how key prevention is," said Doug Matheny, chief of the tobacco use prevention service in the Oklahoma State Department of Health. "Tobacco use is the No. 1 preventable cause of death in the U.S."

He said the latest death rates stem from the state's smoking prevalence in the 1990s.

"Almost every Oklahoman has lost a friend or loved one from smoking cigarettes ," Matheny said. "It is a major contributor to the four leading causes of death in the state: heart disease, cancer, stroke and chronic obstructive pulmonary disease."

The report's authors gathered average annual smoking-death-rate data for all states and the District of Columbia among adults who are 35 or older. Deaths from secondhand smoke exposure were not included.

Oklahoma's smoking-death rate is the fifth-highest in the U.S.

Oklahoma is one of 17 states and the District of Columbia where the death rate climbed among women. Surprisingly, smoking-death rates declined in men in 49 states and the District of Columbia, but they declined in women in only 32 states, according to the report.

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Knode, 39, of Tulsa said she might never stop smoking. She started when she was 10.

"I'd like to quit," she said. "But when I try to quit, it causes me a lot of anxiety," she said.

Knode said she has seen many family friends who never smoked or drank alcohol die early from some form of cancer.

Yet her own mother, who smoked and drank for years, is now 77. She only recently was diagnosed with lung cancer.

"I just don't see the justice and balance for (quitting) in my own personal life," she said.

According to the report, Kentucky had the highest overall death rate, at 371 deaths per 100,000. The lowest was Utah's 138 deaths per 100,000.

The decline in overall smoking-death rates in 49 states and the District of Columbia reflects the "progress made in lowering smoking prevalence in the United States during the past 40 years," report authors wrote.

Recently, the American Lung Association gave Oklahoma a grade of F for the level of tobacco prevention funding in 2008.

However, all but seven states received the same grade in that category.

The report's authors recommend that programs aimed at preventing people from starting to smoke and helping people quit smoking should be fully implemented.

They also recommend that states fund tobacco control programs at the levels recommended by the CDC.

The CDC recommends that Oklahoma spend $45 million each year on tobacco control programs, more than twice the $19 million Oklahoma now spends.

"We are starting to do some of the right things in Oklahoma to try to turn around this huge problem," Matheny said. "And we are starting to see results."