Hawaii’s adult smoking rate has dropped 17 percent in a decade to one of the lowest in the country, and the state will now focus its efforts on specific groups that haven’t kept up with the societal shift, including Native Hawaiians.

“While we’ve made great strides in lowering smoking rates and improving related health outcomes, these benefits are not reaching everyone in our state,” said Dr. Keawe Kaholokula, who chairs the Coalition for a Tobacco-Free Hawaii and the University of Hawaii medical school’s Department of Native Hawaiian Health.

He spoke at an event Thursday at the Capitol marking the 10th anniversary of the passage of Hawaii’s Clean Indoor Air Act. The gathering celebrated the state’s progress and unveiled the state’s 2016-2020 plan to help “priority populations” avoid or overcome nicotine addiction.

The adult smoking rate has fallen to 14 percent, down from 17 percent in 2005, propelled by a broad-based push to restrict the practice and help people quit. But the rate remains nearly twice as high for Native Hawaiians and people diagnosed with depression, at 27 percent, Health Department data show.

People living below the poverty line in Hawaii are also more likely to smoke, with 1 in 4 lighting up regularly, despite high cigarette taxes. The rate is roughly the same for people who identify as lesbian, bisexual, gay and transgender. Heavy drinkers are the most likely to smoke, at 29 percent.

With the dangers of tobacco now well understood, prevention efforts will lean toward offering support and encouragement to quit or to avoid even starting, rather than painting dire scenarios.

The Clean Indoor Air Act, also known as the “Smoke-Free Workplaces Law,” passed in 2006, prohibited smoking in enclosed and partly enclosed areas statewide, expanding on county efforts. Since then the state has banned the sale of electronic smoking devices to minors, made state parks smoke-free and added e-cigarettes to smoking prohibitions.

“Most of us take clean indoor air for granted today,” said Dr. Virginia Pressler, state health director. “We can’t imagine being exposed to secondhand smoke … but it hasn’t always been that way.”

She added, “These policies are effective not only in protecting people from secondhand smoke, but in helping smokers kick the habit. There is still work to be done to reach the goal of a tobacco-free Hawaii. It still hurts me to see anybody smoking these days. But we’ve done a good job trying to de-normalize it, and I think we’ve come a long way.”

HAWAII NOW has the third-lowest rate of adult smoking in the country, behind Utah and California. This year the Aloha State became the first in the country to ban tobacco and e-cigarette sales to people below age 21.

Smoking rates among high school and middle school students in the islands have dropped by more than 50 percent over the last decade, Pressler said. Still, electronic cigarettes have proved enticing to teens, and the state’s new plan focuses on preventing them from starting and using any tobacco product.

Deaths from chronic disease, such as lung cancer, stroke and heart disease, have dropped along with the smoking rate, and so have medical costs, Pressler noted. The reduction in adult smoking in the last decade saved $275 million in long-term health costs and $37 million in Medicaid costs paid by the state, she said.

THURSDAY was the 41st annual Great American Smokeout, a national effort to get smokers to kick the habit. John Robitscher, CEO of the National Association of Chronic Disease Directors, congratulated Hawaii on its successful efforts so far.

“With the kinds of coalitions you have built here, you are a model to the nation,” Robitscher said at the Capitol. “We want to make sure that your success and your stories and how you did it get relayed to other states so they can follow your example.”

The Hawaii Tobacco Quitline, at 800-QUIT-NOW, offers free help to smokers and relatives of tobacco users, including a personalized quit plan; free nicotine replacement patches, gum or lozenges; and educational materials. Telephone or web-based counseling is available through hawaii quitline.org.

A new 10-minute video focusing on Hawaii’s experience in reducing tobacco use as well as the 2016-2020 Strategic Plan for Tobacco Use Prevention and Control in Hawaii are available online at health. hawaii.gov/tobacco.