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The American Lung Association says fewer Americans smoke cigarettes now than before tobacco control policies were put in place.

In its annual report, the ALA says smoking rates among adults and teens are at historic lows. On average, just over 15.5 percent of American adults and eight percent of high school students smoke cigarettes.

The association gets its data from the Centers for Disease Control and Prevention which show the smoking rate declined from 20.9 percent in 2005 to 15.5 percent in 2016. Still, CDC data shows that nearly 38 million American adults continue to smoke.

Yet, the American Lung Association finds that certain groups and regions in the United States are disproportionately impacted by tobacco use and exposure to second-hand smoke. Thomas Carr, the ALA's Director of National Policy who wrote the 2018 report "The State of Tobacco Control," said poorer Americans, those who are less educated, Native Americans and some ethnic groups have smoking rates that are close to 30 percent or higher.

There's also peer pressure, and when friends or parents smoke, teens tend to take up the habit. Studies show that most people who smoke start before they are 18. Some start as young as age 11 according to The Campaign for Tobacco-Free Kids. Carr calls it a pediatric disease. "It starts in your teens and then once you're hooked, you can't get off of it."

The lung association is pushing states to raise the age where young people can legally purchase cigarettes to 21, the minimum age in the United States for purchasing alcohol. The thought is that if middle and high school students can't get cigarettes, they are less likely to start smoking.

The lung association issues an annual report to help promote state and federal regulations to make it easier for people who smoke to quit and to help those who don't smoke not to start.