According to a recent report by the American Lung Association, Alabama received a failing grade in all categories of tobacco prevention.

In the association’s annual State of Tobacco Control 2013 study, Alabama failed in categories of tobacco prevention and control program funding, smoke-free air, cigarette tax and cessation coverage. According to the study, Alabama ranked seventh in the nation for smoking-related deaths.

Michelle Bernth, senior vice president of marketing for the American Lung Association, said Alabama received an “F’ in the first category of the study, tobacco prevention and control program funding, because it’s major lack of state spending on tobacco prevention programs.

“The Centers for Disease Control gives a recommended minimum spending level for each state in terms of tobacco preventative programs,” Bernth said. “Right now Alabama is spending 5 percent of that minimum recommended level. That’s extremely low.”

The CDC recommends Alabama allocate $56.7 million to tobacco prevention programs. According to the report, Alabama has spent $3.3 million with the majority of those dollars being federal funds.

The next category, smoke free air, pertains to state laws setting precedents for smoking in public places.

“Alabama has no statewide law that protects restaurants, work places and bars,” Bernth said. “There are some local strides to cut out smoking in public places but on a state level, Alabama has no laws protecting individuals from second-hand smoke.”

According to the report, Alabama also has the fifth lowest cigarette tax in the country at 42.5 cents per pack, giving the state an F in the cigarette tax category.

Don Williamson, state health officer for the Alabama Department of Public Health, said this low tax is what often drives the high purchase rate of tobacco in Alabama.

“There’s a clear and almost linear relationship between the size of your tobacco tax and the number of people who smoke,” Williamson said, adding that the lack of a clean-air bill also contributes to the high amount of smokers in the state.

According to the American Lung Association study, Alabama also received an F in the report for cessation coverage, which encompasses support programs offered to current smokers.

“Cessation coverage looks at Medicaid recipients and state health employees and what kinds of plans the state provides them with to quit smoking,” Bernth said.

According to the report, Alabama only provides full coverage, which is the seven recommended cessation medications, to pregnant women. Also, the coverage that Alabama does provide is only available for a certain number of “quit attempts,” Bernth explained.

“That means that once you hit a certain number of times that you’ve said ‘I want medication’ or ‘I want counseling to try and quit smoking’ and then you start smoking again, there’s a limit on how many times you can try to quit,” Bernth said. “That’s a real problem because we know it takes the average smoker more than six quit attempts to actually quit for good.”

Those on Medicaid are a population the study specifically looks at, Bernth said, because lower socioeconomic individuals are more likely to smoke.

“Because this is the case, we strongly feel that this group needs extra support,” Bernth said.

On a state level, Williamson said that while attempts have been made to change these numbers, but little progress has been made.

“I think you have to continue to pursue that legislation, it is a long term strategy,” Williamson said. “Also I would encourage people to support activities that reduce tobacco consumption.”