The report cards are in, and Idaho won't be on the dean's list.

According to a Jan. 20 press release, the American Lung Association recently graded all 50 states on their respective tobacco control policies. Idaho received a failing grade in three out of four categories: tobacco prevention and control spending, cigarette tax and cessation.

The Gem State's only bright spot was a "B" grade in the smokefree air category.

"For Idaho, it is time to move forward with renewed resolve to reduce the devastating levels of death and disease caused by tobacco use," Renee Klein, president and CEO of the American Lung Association of the Mountain Pacific, said in the release. "When states get low or failing grades, the result is human tragedy. The report card clearly tells what Idaho can do dramatically better."

In the 2011 fiscal year, the total funding available for Idaho state tobacco control programs is around $3.8 million, according to the ALA. For comparison, Wyoming - a state that received a "B" grade in the spending category - has $6.7 million in tobacco control funding at its disposal.

Those numbers include funding from the Centers for Disease Control and Prevention, along with grants from federal funds, the ALA noted. Additionally, much of Idaho's $3.8 million comes from the Tobacco Settlement Funds, explained Linda Harder, a health education specialist senior for Panhandle Health District (PHD).

She said Idaho legislators have approached regional health districts to collect data on smokers and tobacco-use programs, so that state money can be better utilized.

"We've been providing information on the number of people we've been able to serve, our cessation rates, and stuff like that," Harder said. "We've seen good success. And we'd like to be able to increase our services."

PHD offers consultation and classes for tobacco users looking to quit, and posts tobacco information on its website. The district also works with cities and park districts to implement policies that limit tobacco use.

Seventy adults and 85 teens went through PHD's quit-tobacco programs last year, Harder reported.

"And we had a success rate that is between 50 and 55 percent," she added, meaning about half the tobacco users that signed up for a PHD program quit for good. "That's actually a pretty good number when you're dealing with an addiction."

The low grades from the American Lung Association were disappointing, Harder said.

"I think numbers don't lie, so we're trying to do the best we can with the funding we receive," she said.

Idaho's adult smoking rate is currently 16.3 percent, the ALA reported. The rate among high school students is 14.5 percent, and the middle school percentage is 9.4.

"There are 7,000 chemicals in every puff of smoke," said Dr. Timothy Quinn, a general surgeon at Kootenai Medical Center in Coeur d'Alene. "(Smokers) are starting in middle school, and even grade school. Once you start smoking, even in small numbers, your brain adapts and starts creating more nicotine receptors. Once you've been a smoker, your brain is never totally back to normal."

In 2010, there were 1,509 smoking-attributable deaths in Idaho, the ALA said. Of those, over 900 were the result of lung cancer or respiratory disease.

"If you went through our hospital, I would bet one-third of the people are there because of a smoking-related problem," Quinn said.

On average, a smoker will try to quit seven times before finally kicking the habit, he added.

"I think a lot of smokers keep on smoking to avoid the withdrawal symptoms," Quinn said. "One of the most effective things is to raise the taxes on (cigarettes). It is a sin tax, so to speak. But that is one of the most effective deterrents."

The Idaho cigarette tax is 57 cents per pack of 20 - low enough to warrant an "F" on the ALA report card. Washington smokers, however, pay $3.025 in cigarette tax, prompting many to cross the state line in search of cheaper sticks.

Harder said tax raises reduce the overall smoking risk, and help decrease the number of youth who start smoking in the first place.

Idaho's third failing grade came in the cessation category. The ALA listed several barriers to cessation coverage in the state Medicaid program, including an annual limit on quit attempts, counseling required to get medications and a dollar limit on benefits. There is also no coverage provided for tobacco counseling.

State employee health plans fared little better. They cover phone and online counseling, the ALA noted, but require a co-payment for cessation medications. There's a dollar limit in the employee plans, too.

Despite the dismal report card, Idaho smokers are finding ways to quit.

Steven Foxx started smoking about five years ago. His habit began casually, a cigarette here and there, but eventually he was going through a pack a day.

Now he's trying to cut back.

"I actually am using the smart smokes (electronic cigarettes) from the Vapor Cafe on Government Way," said Foxx, who lives in Coeur d'Alene. "It seems as though it's a semi-helpful technique."

He's down to five sticks per day.

Pat Shearer, a 21-year-old North Idaho College student and smoker, said he was aware of local stop-smoking aids, though he had not heard about any programs for NIC students.

Regardless, it's ultimately the smoker's decision, he said. There are ways to stop.

"It is mostly your choice whether or not you want to quit or not," Shearer said.