The American Lung Association is fuming over what many states are spending tobacco settlement money on.

A report finds that most states spend only a fraction of what federal health officials have recommended on anti-tobacco programs at schools and counseling to help people quit smoking.

The association gives 32 states and the District of Columbia a failing grade for spending on anti-tobacco programs. Only six states earned an "A."

Forty-three states and the District of Columbia received an “F” in smokefree air laws; 17 received “Fs” in tobacco taxes, and 28 received an “F” in laws limiting youth access to tobacco.

Those grades help illustrate why smoking costs the United States approximately $150 billion each year in health-care costs and lost productivity.

Only four states—California, Maine, New York and Rhode Island—scored the highest achievement of two grades of "A."

Extended Web Coverage

State of Tobacco Control: 2002

Smokefree Air

• The American Lung Association advocates for the enactment and enforcement of measures to eliminate the exposure of children and adults to secondhand smoke, with emphasis on work sites.

• Areas of special concern include schools, day care centers, health care facilities, and publicly owned buildings and facilities.

• The ALS wants to establish a minimum standard that local governments can build upon to provide additional protection.

Youth Access
The American Lung Associated recommends you access laws that:

• Monitor tobacco retail outlets, with a graduated series of penalties to the retailer for sales of tobacco to minors, culminating in license suspension or revocation for repeated violations;

• Authorize state or local governments to carry out random, unannounced inspections of retail outlets, including authorization for minors’ participation in carrying out such inspections;

• Eliminate tobacco vending machines;

• Eliminate sales of single cigarettes or “loosies”;

• Require that all tobacco products be displayed only behind the sales counter; and

• Prohibit distribution of free tobacco product samples.

Tobacco Prevention and Control Spending

• The American Lung Association recommends allocating a significant portion of state settlement funds to effective tobacco prevention and education programs, and adopting the Centers for Disease Control and Prevention (CDC) guidelines as the basis for building a comprehensive tobacco prevention and education program.

• The CDC’s Best Practices for Comprehensive Tobacco Control Programs guidelines recommend including the following nine programs in any comprehensive program:
  
  • Community programs to reduce tobacco use chronic disease programs to reduce the burden of tobacco-related diseases
    
  • School programs
    
  • Enforcement
    
  • Statewide programs include counter-marketing
    
  • Cessation programs
    
  • Surveillance
    
  • Evaluation
    
  • Administration
    
  • Management

Cigarette Tax
The American Lung Association encourages the following
action:

• Enactment of significant increases in the excise tax on all tobacco products;
  
• Indexing tobacco taxes to ensure that tobacco taxes will, at a minimum, keep up with inflation; and
  
• Designating a portion of the tobacco tax revenue to cover tobacco education, prevention and cessation programs.

Grades by State:

Alabama

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  Alaska
  

• Smokefree Air – F
  
• Youth Access – B
  
• Tobacco Prevention and Control Spending – C
  
• Cigarette Taxes – B

  Arizona
  

• Smokefree Air – F
  
• Youth Access – C
  
• Tobacco Prevention and Control Spending – D
  
• Cigarette Taxes – B

  Arkansas
  

• Smokefree Air – F
  
• Youth Access – D
  
• Tobacco Prevention and Control Spending – A
  
• Cigarette Taxes – D

  California
  

• Smokefree Air – A
  
• Youth Access – A
  
• Tobacco Prevention and Control Spending – D
  
• Cigarette Taxes – C

  Colorado
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – D
  
• Cigarette Taxes – F

  Connecticut
  

• Smokefree Air – F
  
• Youth Access – A
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – B

  Delaware
  

• Smokefree Air – A
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – D
  
• Cigarette Taxes – F

  Florida
  

• Smokefree Air – I
  
• Youth Access – D
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – D

  Georgia
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  Hawaii
  

• Smokefree Air – F
  
• Youth Access – D
  
• Tobacco Prevention and Control Spending – D
  
• Cigarette Taxes – B

  Idaho
  

• Smokefree Air – F
  
• Youth Access – B
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  Illinois
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – B

  Indiana
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – A
  
• Cigarette Taxes – D

  Iowa
  

• Smokefree Air – F
  
• Youth Access – C
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – D

  Kansas
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – C

  Kentucky
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  Louisiana
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – D

  Maine
  

• Smokefree Air – C
  
• Youth Access – A
  
• Tobacco Prevention and Control Spending – A
  
• Cigarette Taxes – B

  Maryland
  

• Smokefree Air – B
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – A
  
• Cigarette Taxes – B

  Massachusetts
  

• Smokefree Air – F
  
• Youth Access – C
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – A

  Michigan
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – A

  Minnesota
  

• Smokefree Air – F
  
• Youth Access – C
  
• Tobacco Prevention and Control Spending – A
  
• Cigarette Taxes – D

  Mississippi
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – A
  
• Cigarette Taxes – F

  Missouri
  

• Smokefree Air – F
  
• Youth Access – C
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  Montana
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  Nebraska
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – C

  Nevada
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – D

  New Hampshire
  

• Smokefree Air – F
  
• Youth Access – C
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – D

  New Jersey
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – D
  
• Cigarette Taxes – A

  New Mexico
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  New York
  

• Smokefree Air – F
  
• Youth Access – A
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – A

  North Carolina
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  North Dakota
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – D

  Ohio
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – D

  Oklahoma
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  Oregon
  

• Smokefree Air – D
  
• Youth Access – D
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – A

  Pennsylvania
  

• Smokefree Air – F
  
• Youth Access – D
  
• Tobacco Prevention and Control Spending – B
  
• Cigarette Taxes – B

  Rhode Island
  

• Smokefree Air – F
  
• Youth Access – A
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – A

  South Carolina
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  South Dakota
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – D

  Tennessee
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  Texas
  

• Smokefree Air – F
  
• Youth Access – A
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – D

  Utah
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – C

  Vermont
  

• Smokefree Air – B
  
• Youth Access – A
  
• Tobacco Prevention and Control Spending – B
  
• Cigarette Taxes – B

  Virginia
  

• Smokefree Air – F
  
• Youth Access – D
  
• Tobacco Prevention and Control Spending – D
  
• Cigarette Taxes – F

  Washington
  

• Smokefree Air – F
  
• Youth Access – C
  
• Tobacco Prevention and Control Spending – B
  
• Cigarette Taxes – A

  West Virginia
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – F

  Wisconsin
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – F
  
• Cigarette Taxes – C

  Wyoming
  

• Smokefree Air – F
  
• Youth Access – F
  
• Tobacco Prevention and Control Spending – D
  
• Cigarette Taxes – F

Source: http://www.lungusa.org/ (The American Lung Association Web site) contributed to this report