"We’d like everybody to stop smoking or never start in the first place. It would save an enormous amount on health care costs."
— U.S. Health and Human Services Secretary Kathleen Sebelius,
July 15, 2009

The American Lung Association's State of Tobacco Control report tracks progress on key tobacco control policies at the state and federal levels and gives grades to tobacco control laws and regulations in effect as of January 2, 2010. The federal government, all 50 state governments and the District of Columbia are graded to determine if their tobacco control laws are adequately protecting citizens from the enormous burden caused by tobacco use.

During the nation's recent health care reform discussion, the importance of prevention and wellness played a prominent role. Tobacco control policies are at the heart of preventing and reducing the leading cause of preventable death in the United States, as more than 443,000 Americans die each year due to tobacco-related diseases.¹ In addition to the devastating human toll caused by tobacco use, smoking costs the U.S. economy more than $193 billion each year—including $96 billion in health care costs and $97 billion in lost productivity.²

Mounting scientific evidence shows that effective tobacco control policies lead to fewer kids starting to smoke and more smokers quitting. However, elected officials continue to fail to enact these proven measures. In this year's report not a single state or the federal government qualified for all "A" grades for enacting strong and effective tobacco control laws. Ironically, this comes at a time when tobacco control policies, such as smokefree laws, are extraordinarily popular with the public. However, until elected officials overcome their fears of standing up to the tobacco industry lobby, more lives will be needlessly lost and billions of dollars will continue to be wasted.

Tobacco's Grim Statistics
»Each year, more than 393,000 Americans die from smoking-caused diseases.
»Another 50,000 die from exposure to secondhand smoke.
»Each day, almost 3,900 kids try their first cigarette.
»More than 950 become regular, daily smokers.³

Each state's grades reflect how well the state's tobacco control laws measure up to the best in the nation or to goals set by federal agencies such as the Centers for Disease Control and Prevention (CDC). Many states have hard-working tobacco control coalitions that encounter stiff resistance from state legislators and powerful tobacco interests. The grades in this report in no way reflect the level of effort invested by the public health community. Instead, it is the responsibility of elected officials to muster the political will to enact these life- and revenue-saving policies.

Despite progress made in 2009, especially at the federal level, much work remains. Tobacco use continues to be the leading cause of preventable death in the United States; states and the federal government are still failing to enact all of the policies that will reduce its staggering toll. While the public health community can be proud of its achievements, it must not rest for a moment in pressing to enact the life-saving policies called for in State of Tobacco Control.