WEDNESDAY, Jan. 31, 2018 (HealthDay News) — While the overall smoking rate has plummeted among Americans, some smokers still struggle with the habit, a new report shows.

The overall smoking rate fell from 42 percent in 1965 to 15 percent in 2015. But rates remain high among those who are: poor; less educated; part of the lesbian, gay, bisexual and transgender (LGBT) community; members of certain ethnic/racial groups; the mentally ill; those in the military.

“The high prevalence of cigarette smoking among vulnerable populations is one of the most pressing challenges facing the tobacco control community,” wrote the researchers from the American Cancer Society.

“More attention to and support for promising novel interventions, in addition to new attempts at reaching these populations through conventional interventions that have proven to be effective, are crucial going forward to find new ways to address these disparities,” they added.

According to the report, while only 6.5 percent of college-educated people smoke, the rate was 23 percent among those with a high school education or less. And smoking rates were about 10 percent for adults in higher-income households, compared with nearly 25 percent for adults in households below the poverty line.

Asian and Hispanic Americans had the lowest smoking rates (12.6 percent for males and 3.5 percent for females), while American Indian/Alaskan Natives had the highest rates (24 percent for males and 23 percent for females), the findings showed.

The smoking rate among people with a serious mental illness in the past year was almost 28 percent, compared with nearly 13 percent among those without a past-year mental illness. The risk of smoking was higher among people with certain types of mental illness. For example, the rate was nearly 60 percent among people with schizophrenia.

The smoking rate among LGBT people was much higher than among heterosexuals. Research suggests that hostility faced by LGBT people can trigger stress that may prompt smoking. Also, the tobacco industry has long targeted the LGBT community, according to the report published Jan. 31 in CA: A Cancer Journal for Clinicians.

The researchers also found that smoking rates are higher in the military (24 percent in 2011) than in the general population, and that rates are highest among those with the four lowest pay grades (30 percent).

There was also considerable variation in smoking rates among states, ranging from under 9 percent in Utah to just over 26 percent in Kentucky. A “smoking belt” stretches from Michigan to Mississippi, and includes several adjacent states in the Midwest and Appalachia, according to the report.

More information

The American Cancer Society offers a guide to quitting smoking.