https://www.lung.org/research/sotc The 22nd annual American Lung Association “State of Tobacco Control” report evaluates states and the federal government on the proven-effective tobacco control laws and policies necessary to save lives. The report serves as a blueprint for what state and federal leaders need to do to eliminate the death and disease caused by tobacco use. In the report, the Lung Association assigns letter grades, A through F, to the state and federal policies best proven to prevent and reduce tobacco use.