RALEIGH, N.C.(WNCN) — North Carolina earned straight F’s in a tobacco-use report from the American Lung Association.

The State of Tobacco Control, released Tuesday by the ALA, graded states on their policies to prevent and reduce tobacco use. North Carolina failed in the five key areas reviewed by the organization.

North Carolina is listed as one of the states with the worst policies to prevent and reduce tobacco use, according to the report. The state earned all failing grades in this year’s report.

The American Lung Association says tobacco use remains the leading cause of preventable death and disease in the country. The association says tobacco takes the lives of 14,220 North Carolina residents each year.

“North Carolina lags behind when it comes to tobacco control policies, and, as a result, we have higher than average adult smoking rates at 14.4 percent and 27.3 percent of high school students use a tobacco product,” said Danna Thompson, director of Advocacy at the American Lung Association in North Carolina.

North Carolina earned an F in the following categories:

  • Funding for state tobacco prevention programs
  • Strength of smokefree workplace laws
  • Level of state tobacco taxes
  • Coverage and access to services to quit tobacco 
  • Ending the sale of all flavored tobacco products

The ALA is pushing for more funding of state tobacco-use prevention and smoking cessation programs. They say the investment is especially important given the number of underage children who vape. The organization is urging that more funds from tobacco settlement payments and tobacco taxes be used.

ALA also gave the federal government grades for its overall efforts:

  • Federal government regulation of tobacco products — Grade C
  • Federal coverage of quit smoking treatments — Grade D
  • Level of federal tobacco taxes — Grade F
  • Federal mass media campaigns to Prevent and Reduce Tobacco Use — Grade A
  • Federal minimum age of sale for tobacco products to 21 — Incomplete