LAS VEGAS (KLAS) — The American Lung Association released its annual report card Wednesday morning and once again Nevada received failing grades when it comes to tobacco prevention.

According to the annual report, 14.2% of adults smoke in Nevada and the tobacco use rate among high school students is 21.4%. It’s estimated smoking contributes to 4,050 deaths every year in Nevada and remains the leading cause of preventable death and disease.

Nevada is one of 22 states without a widespread indoor smoking ban which is something the American Lung Association is pushing for statewide.

“Everyone deserves to work and play in a smoke-free place and not have to breathe indoor smoke. So, what we’re hoping is just to continue those education efforts. We know we’re up against a big industry that has a lot of influence,” said Joanna Strother, the senior director of advocacy for the American Lung Association in Nevada.

Smoking is prevalent in nearly all casinos however some such as the Park MGM reopened as a smoke-free casino and others have designated smoke-free areas.

Nevada received failing grades in the following areas:

  • Funding for prevention programs
  • Level of state tobacco taxes
  • Coverage and access to services to quit 
  • Ending the sale of all flavored tobacco products

The state did score higher than an “F” in its “strength of smoke-free workplace laws.” The state received a “C” grade.

The advocacy group says products, like e-cigarettes create great concern as well as the use of flavored tobacco by teens.