New Jersey's come home with a mostly bad report card.

According to an annual report released Wednesday by the American Lung Association, the Garden State receives a 'D' or 'F' grade in most areas related to tobacco use, the nation's leading cause of preventable death and disease.

"In New Jersey our adult smoking rates are 13.1% and our youth e-cigarette rate is 27.6%," said Michael Seilback, American Lung Association assistant vice president for state public policy. "The surge in youth vaping combined with the fact that smoking increases the chance of severe COVID-19 symptoms, make it more important than ever for New Jersey to implement the proven measures outlined in 'State of Tobacco Control' to prevent and reduce tobacco use."

The state received an 'A' grade for its strength of smokefree workplace laws — New Jersey prohibits smoking in mostly all indoor spaces. But the association is pushing New Jersey to go even further, by also including Atlantic City casinos in the ban. Smoking remains off-limits at the nine gaming halls during the pandemic.

"The U.S. Surgeon General has concluded there is no safe level of exposure to secondhand smoke," the report states.

Because New Jersey spends less than 10% of what's recommended by the Centers for Disease Control and Prevention for tobacco control programs, the state received a failing grade for prevention and control programs funding. It also flunked for its cigarette tax rate of $2.70 per pack. The association encourages the state to increase taxes by $1.65 per pack and equalize the tax on other products.

By doing this, Seilback said, the state could discourage usage among youth, and devote more funding to prevention and cessation.

Gov. Phil Murphy's 2021 proposed budget included a $1.65 increase in the cigarette tax, but it was not included in the signed product.

The legal smoking age in New Jersey is 21. New Jersey in early 2020 put an end to the sale of flavored vaping products, which reportedly exist to hook young people.

But, according to a new category in the American Lung Association's report, New Jersey could go much further in this area as well. The association wants states to end of the sale of all flavored tobacco products, including menthol cigarettes. Menthol-flavored cigarettes were part of a proposed New Jersey ban in 2019, but they did not make their way into the law.

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