North Carolina got failing grades in its efforts to curb tobacco use.
A new report released by the American Lung Association, the "State of Tobacco Control" report, gives North Carolina an "F" in every category.
That includes use prevention, access to services that help people quit and smoke-free air.
The report also shows North Carolina has the fourth-lowest tobacco tax in the country and does not restrict the sale of flavored tobacco products.
More than 14 percent of adults in North Carolina smoke, according to the report, and 27 percent of high school students use tobacco.
It puts North Carolina health cares costs due to smoking at nearly $4 Billion.
North Carolina is one of only four states to get straight F's on the report.
Read the full report HERE.