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The 2024 State of Tobacco Control report grades the federal government in five areas: Federal 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* *FDA is overdue in finalizing the Tobacco 21 regulations as required by statute State Grades Overview The 2024 State of Tobacco Control report grades states and the District of Columbia in five areas that have been proven to prevent and reduce tobacco use and save lives: Strength of Smokefree Workplace Laws 16 states and Washington DC earned A grades Ending the Sale of All Flavored Tobacco Products 45 states earned F grades Funding for State Tobacco Prevention Programs 41 states and Washington DC earned F grades Level of State Tobacco Taxes 31 states earned F grades Coverage and Access to Services to Quit Tobacco 20 states and Washington DC earned A or B grades Best Graded States California: Tobacco Program Funding: C, Smokefree Air: A, Tobacco Taxes: C, Access to Cessation: A, Flavored Tobacco Products: B District of Columbia: Tobacco Program Funding: F, Smokefree Air: A, Tobacco Taxes: A, Access to Cessation: B, Flavored Tobacco Products: A Massachusetts: Tobacco Program Funding: F, Smokefree Air: A, Tobacco Taxes: B, Access to Cessation: B, Flavored Tobacco Products: A Worst Graded States Alabama and Georgia rated the worst in the nation, scoring Fs in all five categories Mississippi, North Carolina, Tennessee, Texas, and West Virginia received 4 Fs and 1 D grade The report finds that federal, state, and local governments need to do more to stand up against the tobacco industry and reduce tobacco use, especially among youth

This can create a mutual effect in the brain when nicotine and alcohol are consumed together, reinforcing each others addictive properties

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