KNOXVILLE, Tenn. — Tennessee is failing in the fight against tobacco use, according to a new report. In the American Lung Association’s (ALA) recent State of Tobacco Control Report, Tennessee received an “F” grade in four out of five categories.

Those categories are Tobacco Prevention (F), Smoke-free Air (C), Tobacco Taxes (F), Access to Cessation Services (F), and Flavored Tobacco Products (F).

These grades are important because the CDC found more than 11,000 Tennesseans die each year due to smoking-related issues. The ALA said these report cards show a direct link between those deaths and other lung-related diseases.

Prevention is one of the biggest issues, said Shannon Baker with the ALA.

“In Tennessee, the grade for funding is an ‘F grade,’ because the funding level is $2 million, and CDC recommends about $75 million,” Baker said.

She said the discrepancy in funding is what’s making Tennessee lag behind other states. Baker explained that funding is used for ad campaigns and other cessations programs.

“For example, it can be used for a quitline, which you do have in Tennessee. But then, perhaps also a media campaign that drives people to that quitline,” Baker said.

The more funding that goes into these programs and campaigns, the more people they will reach and the more successful they will be at getting people to quit tobacco products, she said.

Baker said the ALA wants those anti-tobacco ad campaigns to specifically target young people.

“If we can keep kids from initiation, beginning to use tobacco products before age 18, we’ve probably prevented initiation entirely,” Baker said.

However, some children under 18 years old have already dappled with tobacco and nicotine products.

The ALA report shows about 27% of high school students are using tobacco products. That’s even more than about 20% of adults who use tobacco. Baker said that number could be higher. Some types of vapes are excluded from that count due to what she calls a “loophole.”

“There is such a thing now as synthetic nicotine, and kids are now using these products because they are accessible to them,” she said.

Synthetic nicotine is made in a lab. Therefore, it is not derived from a tobacco leaf. Meaning, it is not legally considered a tobacco product.

“Puff bars in particular are the most popular e-cigarette device among youth now, and that’s a synthetic nicotine product,” Baker said.

She said oftentimes, synthetic e-cigarettes can contain very high, addictive levels of nicotine. Also, many of the vapes have flavors that appeal to younger crowds.

Baker said the first steps for the state would be to crack down on underage use and bring more funding into the state.

“There’s always hope, right. and so we fight the battle as on all the brands as it’s required. The important thing is to ensure that the focus is on sales,” she said.

Tennessee recently settled a lawsuit with JUUL, a vaping company. There were 33 states involved in that lawsuit, and the company settled for a total of $430 million.

Tennessee received $13 million to help fund prevention efforts.