In every other category Georgia got an F.
Those included funding for prevention programs, access to assistance for those who want to quit, state tobacco taxes, and laws prohibiting smoking until the age of 21.
Bad grades weren’t unusual — the most common grade in most categories for most states was an F.
But where Georgia really stood out was spending.
Georgia’s tobacco tax ranks 48th out of 50 states, at only 37 cents per pack. The national average is $1.71 per pack.
And Georgia doesn’t come close to spending what the U.S. Centers for Disease Control and Prevention recommended on smoking prevention and services for those who want to quit.
Georgia has fallen way behind in spending on smoking programs since the days when tobacco companies first settled a lawsuit with states back in 1998, according to the report. The companies paid states billions of dollars for causing them higher medical costs by knowingly fueling Americans' addiction to cigarettes.
Georgia has received well over $1 billion since the settlement. But the money goes to the state’s general fund for the state Legislature to decide how to spend.
In this fiscal year, the association says Georgia is spending $930,000 on tobacco cessation and prevention, in addition to $2.3 million in federal money. That adds up to just 3 percent of what the CDC would recommend.
Only one other state, Missouri, spends so little on the programs. Most spend far more, and Alaska spends even more than what the CDC recommends.
Smoking has fallen nationwide, and for several years, Georgia's cigarette smoking rate has been around average or a bit worse than average. But in the last two years available, from 2015 to 2016, the Georgia rate actually rose slightly or plateaued, from 17.7 percent to 17.9 percent of adults.
Georgia instituted a strategic plan on the issue in 2015. A spokeswoman for the Georgia Department of Public Health, Nancy Nydam, noted that Georgians on Medicaid now have access to more quitting aids, including the Quitline, Nicotine Replacement Therapy and face-to-face cessation support.
But use of other tobacco products among youth such as e-cigarettes, hookahs and vaping “continues to be a concern,” she added, “as does exposure to secondhand smoke for minority and low-income populations especially.”
The report was released at the start of Georgia’s annual legislative session, when lawmakers will be deciding how to spend the state’s budget this year. But much of the money is already spoken for and lawmakers are reluctant to spend the $2.3 billion rainy day fund on ongoing costs.
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