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American Lung Association Report Card Flunks Federal Government and Most States for Neglecting to Prevent Tobacco Caused Illness

2009 Presents Tremendous Opportunities to Reverse Tobacco Caused Public Health Crisis

Editor's Note: Complete report including federal and state grades available at:

WASHINGTON, Jan. 13 /PRNewswire-USNewswire/ -- The American Lung Association released its State of Tobacco Control 2008 report today, which includes a report card that grades the strength of state and federal laws to protect citizens from tobacco caused illness now at the heart of America's chronic disease crisis. The report finds that the federal government and most states failed to enact critical policy measures to protect people from deadly tobacco products.

Tobacco-related illness remains the number-one preventable cause of death in the U.S., claiming more than 393,000 American lives every year and costing our nation $193 billion annually. An additional 50,000 die from exposure to secondhand smoke; the U.S. Surgeon General has declared that there is no safe level of exposure to secondhand smoke.

"Political leaders have a duty to reduce death and disease caused by tobacco use," said Charles D. Connor, President and CEO of the American Lung Association. "Our new leaders in Washington have an unprecedented opportunity to change the direction of public health by taking steps that ultimately will save millions of lives and hundreds of billions of dollars for the American economy. During these economically challenged times, it simply cannot be ignored that investing in tobacco prevention and cessation programs is one of the most cost effective ways to improve our nation's health while trimming the bottom line."

State of Tobacco Control 2008 grades are calculated by comparing policies against targets that are based on the most current, recognized scientific criteria for effective tobacco control measures.


Despite a number of strong steps forward in 2008 including the House passage of a bill that would allow the Food and Drug Administration (FDA) to regulate the tobacco industry, the federal government again failed to fully enact meaningful tobacco control legislation.

The American Lung Association calculates federal tobacco control grades based on the following:

  • FDA regulation of tobacco products
  • Coverage of tobacco cessation treatments
  • Amount of federal cigarette tax
  • Ratification of the Framework Convention on Tobacco Control (the international tobacco control treaty)

Federal grades:

  • "F" for FDA Regulation of Tobacco Products -- The bill authorizing FDA regulation of tobacco products passed overwhelmingly in the U.S. House of Representatives but was not considered by the U.S. Senate before they adjourned for 2008. The American Lung Association urges the Congress and President-Elect Obama to prioritize the FDA's regulation of manufactured tobacco products in 2009. The legislation has tremendous bipartisan support and has been endorsed by 700 public health, faith, education and children's groups.
  • "F" for Cessation -- The federal government's policies on cessation coverage are weak or nonexistent. While the Medicare prescription drug benefit covers smoking cessation drugs for its patients, the federal government does not require state Medicaid programs to cover cessation treatments and services for Medicaid recipients.
  • "F" for Federal Cigarette Tax -- The federal government's cigarette tax is $0.39 (per pack of 20), well below the "F" standard of anything under $0.595. Grading criteria are based on research showing that as the price of cigarettes increases, consumption decreases. Thus, the higher the tax, the better.
  • "D" for Ratification of the Framework Convention on Tobacco Control -- The Bush Administration once again neglected to submit the international tobacco control treaty to the Senate for ratification, leaving the U.S. unable to participate in international negotiations to implement and enforce the treaty.


The American Lung Association updated this year's state grading guidelines to ensure they reflect the most effective tobacco control policies. States and the District of Columbia are graded on the following:

  • Smokefree air laws
  • Cigarette tax rates
  • Tobacco prevention and control programs
  • Coverage of cessation treatments

States continued to fail to enact these critical policy measures in 2008. Instead, state-level political candidates accepted more than $2.5 million in campaign contributions from the tobacco industry in 2008.

State grade highlights:

  • No state received all A's in this report. Alabama, Kentucky, Missouri, North Carolina, South Carolina, Virginia and West Virginia received all F's.
  • No state earned an "A" for offering comprehensive tobacco cessation treatments to its Medicaid recipients and state employees. Six states (Alabama, Connecticut, Georgia, Kentucky, Missouri and Tennessee) do nothing to help the Medicaid population quit smoking; another six states (Delaware, Louisiana, Mississippi, Montana, South Dakota and Wyoming) fail to offer tobacco cessation benefits for state employees.
  • Iowa and Nebraska were the only two states to meet the American Lung Association's Smokefree Air Challenge in 2008 by passing strong smokefree air laws.
  • Only Alaska and Delaware received A's for funding tobacco prevention and control programs at 80 percent or more of the CDC-recommended level; North Dakota voters passed a ballot initiative in November that will fund North Dakota's tobacco control program at the CDC-recommended level next year.
  • Only Massachusetts, New York and the District of Columbia raised cigarette excise taxes in 2008, despite evidence linking increased cigarette prices with decreased smoking rates, especially among youth.

About the American Lung Association: Now in its second century, the American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease. With your generous support, the American Lung Association is "Fighting for Air" through research, education and advocacy. For more information about the American Lung Association, a Charity Navigator Four Star Charity and holder of the Better Business Bureau Wise Giving Guide Seal, or to support the work it does, call 1-800-LUNG-USA (1-800-586-4872) or visit

SOURCE The American Lung Association
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