U.S. states have not lived up to their commitment to devote a major portion of their huge legal settlement with the tobacco industry a decade ago on anti-smoking efforts, health advocacy groups said on Tuesday.

In the 10 years since the landmark deal, the states have received $79.2 billion of the settlement and another $124.3 billion from tobacco taxes, but have spent only about 3 percent of it — $6.5 billion — on tobacco prevention and cessation programs, the groups said in a report.

The deal, which restricted cigarette advertising practices, requires tobacco companies to make annual payments to the states in perpetuity, with total payments estimated at $246 billion over the first 25 years.

The report was issued by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society, American Lung Association and Robert Wood Johnson Foundation.

No state currently is funding tobacco prevention programs at the levels recommended by the U.S. government's Centers for Disease Control and Prevention, and only nine are funding such efforts at even half the recommended level, according to the report.

In November 1998, 46 states settled their lawsuits against the major tobacco companies to recover tobacco-related healthcare costs, joining four states — Mississippi, Texas, Florida and Minnesota — that had reached earlier, individual settlements.

"This report underscores the need for state officials to take a hard look at the devastating impact of tobacco use in their own communities," M. Cass Wheeler, chief executive officer of the American Heart Association, said in a statement.

"They must reassess their priorities and use the money for what it was originally intended - to fund prevention and cessation programs and break the cycle of addiction."

The CDC said in a report last week that the number of U.S. adults who smoke has dropped below 20 percent for the first time on record, although cigarettes still kill 443,000 Americans annually.

The CDC also said that including direct healthcare expenditures and productivity losses, the economic burden of smoking on the United States stands at $193 billion a year.