When it comes to preventable deaths and disease, smoking is still a top killer in the U.S., says a new report from the Centers for Disease Control and Prevention.

Approximately 443,000 people die from cigarette smoking each year, and 8.6 million suffer from a serious illness related to smoking, according to the Tobacco Control State Highlights 2012.

Utah claimed the lowest adult smoking rate of 11.8%, according to the report released last week, while Kentucky topped the charts with 29%. California hovered above Utah at 13.7%. The U.S. median was 21.2%.

Tobacco use was responsible for $193 billion in health-related economic losses from 2000 to 2004, the report said: $96 billion in medical expenses and $97 billion in lost productivity — not to mention 5.1 million years of potential life annually.

On the bright side, the share of American adults who smoke has decreased, according to the CDC, and those who do smoke are smoking fewer cigarettes per day.

But smoking was far more prevalent among American Indians and Alaska natives, as well as those who live below the poverty level and those with less education, the CDC study noted.

“If current smoking trends continue, the national Healthy People 2020 objective to reduce cigarette smoking prevalence to 12% will not be met,” the authors wrote.

The report comes days after a study in the New England Journal of Medicine found that smokers who quit by age 34 can add an extra decade to their lives, and little more than a week after the American Lung Assn. issued a report on tobacco control in the U.S. – a report that was littered with Ds and Fs.

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