FRESNO, Calif. (KFSN) -- The American Lung Association is giving a federal agency and individual state governments poor marks in a new report card evaluating tobacco prevention programs.
In this year's report, no state earned an "A" grade in every category, but California was among those that scored the highest.
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However, here in the Valley, Fresno, Kings, Madera, and Tulare County received an 'F' rating.
Bay Area cities received some of the best scores in the state.
The 17th annual State of Tobacco Control report says the federal government is failing to act to protect kids from e-cigarettes, with levels rising 78 percent from 2017 to 2018.
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Health experts say tobacco is the leading cause of preventable death and disease in the nation.
It kills 480,000 people in the U.S. each year.