The American Lung Association's "State of Tobacco Control" 2018 is a report card that evaluates state and federal tobacco control policies by comparing them against targets based on the most current, recognized criteria for effective tobacco control measures, and translating each state and the federal government's relative progress into a letter grade of "A" through "F." A grade of "A" is assigned for excellent tobacco control policies while an "F" indicates inadequate policies. The principal reference for all state tobacco control laws is the American Lung Association's State Legislated Actions on Tobacco Issues on-line database, available at www.lungusa2.org/slati. The American Lung Association has published this comprehensive summary of state tobacco control laws since 1988. Data for the state cessation section is taken from the American Lung Association's State Cessation Coverage database, available at http://www.lungusa2.org/cessation2.
In response to new data and information, the American Lung Association periodically reviews the methodology for the State of Tobacco Control report, and makes revisions to the methodology for state grading categories if necessary to update the report to use the most current evidence and best practices. Because of the revisions to the state grading methodology in "State of Tobacco Control 2015," state grades from "State of Tobacco Control 2018" cannot be directly compared to grades from "State of Tobacco Control 2014" or earlier reports.
Calculation of State Grades
State level tobacco control policies are graded in five key areas: tobacco prevention and cessation funding, smokefree air laws, state tobacco excise taxes, access to tobacco cessation treatments and services and laws to increase the tobacco sales age to 21. The sources for the targets and the basis of the evaluation criteria are described below.