A new report from the American Lung Association gave South Dakota mostly failing grades on its efforts to reduce and prevent tobacco use.
The association released its 18th annual State of Tobacco Control study Wednesday.
The study gave South Dakota F's in funding for tobacco prevention programs, levels for tobacco taxes, coverage for services to quit tobacco, and minimum age of sale for tobacco products. The state received only one passing grade - a B in strength of smokefree workplace laws.
Researchers say one of the most alarming findings from the study was the increase in vaping usage nationwide.
ALA Director of Health Promotions Pat McKone said South Dakota has a smoking rate of 19 percent. However, the youth vaping rate rose to 27.5 percent - a 135 percent increase in high school e-cigarette use in just the past two years.
McKone said the state can take a number of steps to decrease tobacco use, including raising the cigarette tax and investing in tobacco prevention programs.
The ALA praised a new federal law raising the national tobacco sales age to 21, but the association said Congress also needs to more aggressively target flavored tobacco products.