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Ministers have been warned they need a big effort to meet their target of reducing the number of smokers in Wales by 2020.

Health Minister Lesley Griffiths reiterated plans to ban smoking in cars containing children and young people if a three-year campaign does not work.

Public Health Wales and the Welsh government estimates 23% of adults smoked in 2010, with the target at 16%.

Ash Wales called for a year-by-year plan to meet the target.

Ms Griffiths said the Welsh government would look to further legislation if necessary.

"We launched Fresh Start Wales earlier this year to encourage people not to smoke in cars where there are children and young people," she said.

"If our media campaign doesn't work we will certainly look to legislation and we have to look at every tool we have available."

Ash says there is a particular need for a cut in deprived areas where more people smoke.

Tobacco and Health in Wales, published on Wednesday, found that the number of smokers had fallen considerably since 1978 when 40% of adults in Wales smoked.

But it warned that the fall in rates had slowed down in recent years.

Jointly produced by the Welsh government, the report pulls together new and existing statistics about smoking.

Newly-released figures include the statistic that 27,700 hospital admissions are related to smoking each year in Wales - 5% of the total.

The research also highlights concerns about young men smoking and that one in six females in Wales smoke during pregnancy, the highest figure in the UK.

The report again links more economically and socially deprived areas of Wales with the highest percentages of smokers over 16.

Blaenau Gwent (28%) and Rhondda Cynon Taf (27%) top the list, followed by Merthyr Tydfil, Wrexham, Neath Port Talbot and Torfaen (26%) and Newport (25%).

In Anglesey, Gwynedd and Caerphilly the rate is 24%, with Denbighshire, Powys, Ceredigion, Pembrokeshire, Carmarthenshire and Cardiff on 23%.

The local authority with the lowest percentage is Monmouthshire (19%), ahead of Conwy, Swansea and Bridgend (22%), and Flintshire and Vale of Glamorgan (21%).

The report warns: "Considerable efforts are therefore required to meet the Welsh government's target of 16 per cent by 2020."

Elen de Lacey, chief executive of anti-smoking group Ash Wales, said: "There needs to be a year-on-year plan throughout Wales on how we are going to get down to that 16%.

"Smoking rates in areas like Merthyr Tydfil and Blaenau Gwent are going to have to come down.

"It needs an all-Wales approach and each area needs to take some responsibility to get that [rate] right down in their local area.

"It's a big ask but if everybody works together then it's an achievable aspiration."

Ms de Lacey also called for a "mid-term target" of 2015, as 2020 seemed "quite a long way away".

Dr Judith Greenacre of Public Health Wales described the figures as "a great cause for concern".

"We still have between one-in-four and one-in-five people who smoke or use tobacco very regularly".

Dr Greenacre added that smoking caused more than 5,000 deaths in Wales each year.

"It has a major impact on the individuals who smoke, on their families, on children who exposed to smoke, still, in the home... and on our hospital services and health services in general who are dealing with that burden of ill-health," she said.

But Dr Greenacre said she believed the Welsh government's anti-smoking strategy was "definitely moving in the right direction".

"We've had a lot of initiatives in Wales," she said. "We've been quite bold in the way that we introduced the smoking ban and that is certainly helping, but we still have a long way to go."

Dr Tony Jewell, chief medical officer for Wales, said the nation needed to learn from places such as Singapore, Australia and California, where similar reductions were achieved.

Helen Rogers, director for Wales at the Royal College of Midwives, said she was concerned about smoking among pregnant women.

"These figures are worryingly high and those on women under 20 are alarming. Urgent action is needed to tackle this."