WHEELING, W.Va. (WTRF) – The rate of adults smoking in West Virginia is higher than anywhere else in the country—and the American Lung Association has something to say about it.

They’ve given the Mountain State nearly straight Fs on its latest State of Tobacco Control report card, on areas like prevention programs, tax levels, and ending the sale of flavored tobacco.

The Association is pushing lawmakers to increase funding for ‘quit smoking’ programs, and to pass Governor Justice’s proposal of a one-dollar tax increase.

Experts we talked to say it’s the highest cause of preventable death in the state, with more than four thousand lives lost every year.

The fact is that for far too long, tobacco use has really ravaged communities across West Virginia. And there are proven tools that can be implemented today that are going to save lives.

Michael Seilback, American Lung Association

If you think of all the products that are for sale, smoking is the only one that if you take as directed is actually designed to kill you.

Dr. Robert Herron, Thoracic Surgeon, WVU Medicine Wheeling Hospital

Meanwhile, Ohio received three Fs on this latest report card, but the state was given an A for smoke-free workplace laws, and a B for access to services to quit tobacco.