(CNN) The federal government gets "mostly failing grades on its efforts to prevent and reduce tobacco," a new report from the American Lung Association says.
The 20th annual "State of Tobacco Control" report calls for an end to manufacturing flavored tobacco, saying flavored tobacco products and e-cigarettes jeopardize progress made by tobacco control policy.
More than 2 million high school and middle school students used e-cigarettes in 2021, and 85.8% of high school students and 79.2% of middle school students who used e-cigarettes used flavored products, according to the report.
The 2022 "State of Tobacco Control" gave the federal government the following grades:
"In 2022, the country needs to redouble its efforts to pass the proven policies called for in 'State of Tobacco Control' to help end tobacco use. We can't afford to wait 20 more years and allow another generation to suffer from tobacco-caused addiction, disease and death. This will require a rededication at the federal, state and local levels to save lives," said Harold Wimmer, the president and CEO of the American Lung Association.
The reports urges the FDA to regulate synthetic nicotine as a drug, warning that e-cigarette companies are exploiting synthetic nicotine as an "attempt to evade the Tobacco Control Act."
Overall smoking among adults has declined, according to the report, but smoking remains high among Native America, Alaskan Natives, and lesbian, gay and bisexual adults.
Additionally, menthol cigarettes are a "key factor for tobacco-related death and disease in Black communities."
The report also notes that cigarette sales increased during the Covid-19 pandemic in 2020, however it's not clear whether that "signals higher adult smoking rates, or existing smokers smoking more cigarettes."
This year, the Lung Association is calling on the US Food and Drug Administration to quickly finalize proposals introduced in April 2021 that would remove flavored cigars and menthol from the marketplace by April 2022.
They are also urging the government to limit health plans that are not required to cover treatment to help people quit tobacco use as well as ask Congress to pass the "Quit Because of COVID-19 Act." This legislation would give all Medicaid enrollees access to a tobacco cessation benefit.