Frankfort, KY – A federal study show Kentucky has the highest smoking-related death rate in the nation. The Centers for Disease Control and Prevention's study shows the death rate from smoking in the Commonwealth is about 371 for every 100 thousand adults age 35 and older. The national average is 263 per 100-thousand. The CDC also lists Tennessee as one of the top ten states with high death rates from smoking. The rates follow closely with adult smoking rates in each state- Kentucky also had the highest smoking rate in 2004.