Contrary to long-held belief among public health experts, the smoking rate in Greater Cincinnati is lower than the national average and one of the lowest in the Midwest, according to a federal report being issued today.

        This finding comes as a surprise because Kentucky, Indiana and Ohio still rank among America's top five smoking states and Greater Cincinnati is located on the fringes of tobacco farming country.

        Yet the new report states that Toledo, Ohio, has the nation's highest citywide smoking rate and that considerably more people smoke in Cleveland, Indianapolis, Lexington and Louisville than in Cincinnati.

        “I'm very pleased but very surprised,” said Tracy Sabetta, program director for Tobacco-Free Ohio, a statewide anti-smoking agency. “I had heard that Toledo and Cleveland were ranking way up there, but with Cincinnati being located closer to Kentucky I would have expected (Cincinnati's smoking rate) to be higher.”

        The report is the government's first city-by-city comparison and was issued by the federal Centers for Disease Control and Prevention. It was based on the 2000 Behavioral Risk Factor Surveillance System, which tracks risky behaviors among adults — from smoking to not wearing seat belts. The CDC survey claims to be the world's largest random telephone survey, collecting information from more than 180,000 people a year.

        According to the report:

        • The smoking rate in the Cincinnati metro area was 21.5 percent of adults, slightly lower than the national average for cities of 22.7 percent. In fact, of 20 Midwest cities surveyed by the CDC, 16 posted higher smoking rates than Cincinnati.

        • Toledo ranked No. 1 in the U.S. at 31.2 percent. Indianapolis ranked third at 30.3 percent; Cleveland ranked fourth at 29.8 percent. Meanwhile, Louisville reported 27.5 percent; Lexington, 26.4 percent, and Dayton, 23.2 percent.

        • Among states, Kentucky topped the list of adult smokers at 30.5 percent; Indiana was fourth at 27 percent; and Ohio was fifth at 26.3 percent.

        According to the CDC, tobacco use is the nation's leading cause of preventable death, killing more than 400,000 a year from lung cancer, heart disease, emphysema, accidental fires, and several less common forms of cancer. Smoking also triggers or aggravates asthma, bronchitis, ear infections and sexual impotency.

        Anti-smoking activism might explain some of the reported difference between Cincinnati and other Midwest cities.

        Ms. Sabetta said Cincinnati was “revolutionary” in 1985, when the city board of health restricted smoking in restaurants and most public places. For the past three years, Greater Cincinnati anti-smoking groups have been buying space on billboards and speaking in schools and churches, she said.

        But lots of cities have active anti-smoking groups. And some local governments in Ohio and nationwide have adopted far stricter public smoking rules than Cincinnati.

        Instead, some say the differences in city smoking rates reflect demographic factors.

        “Cities with higher numbers of industrial workers tend to have higher rates of tobacco use,” said Caris Post, spokeswoman for the American Lung Association of Ohio. ""The figures for Toledo and Cleveland would be consistent with that.”

        In Toledo, Lucas County health officials have approved one of the nation's toughest smoking restrictions. It would ban smoking in all restaurants, bars and other indoor public places.

        However, the regulation has been delayed by a court challenge.

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