As students, Tennessee, Georgia and Alabama flunked the no-smoking class.
The three states racked up a row of F's from the American Lung Association's annual report card that grades states on their efforts to curb cigarette usage. The State of Control report looks at four categories: tobacco prevention, control and spending; state smoking restrictions; cigarette tax rate; and state cessation coverage.
Out of the three states, Tennessee has the highest number of smokers -- 20 percent of adults and high school students -- and the highest number of deaths from smoking per 100,000 population.
However, Alabama and Georgia are not far behind in both percentage of smokers or deaths caused by smoking, with all three states ranking high in national percentages.
"If you can't breath, nothing else matters," said Shirley Cudabac, development director for the American Lung Association in Chattanooga. "There are so many statistics out there, but that is really what matters."
In its annual report, the Lung Association found many states regressed in 2011. No state passed a strong smoke-free air law, and Nevada weakened its existing law. No state increased its tobacco tax significantly and more than a dozen states cut or eliminated funding of tobacco control and prevention programs.
Tennessee, Georgia and Alabama all spend only a fraction of the recommended funding for tobacco prevention and control spending.
In addition, three states have some of the lowest cigarette taxes in the nation, with Georgia's ranking fourth lowest, Alabama coming in at fifth and Tennessee adding a few more pennies at the 13th lowest tax in the nation.
It doesn't look as if 2012 will bring many improvements in the tri-state region, said Cudabac, a sentiment echoed by June Deen, state director for the American Lung Association in Georgia.
Although local advocates for the American Lung Association are pushing higher cigarette taxes and more funding for cessation programs, neither seems likely to happen with tight state budgets, they said. Lawmakers are looking to cut programs, not increase them, despite studies that show each dollar spent on cessation programs results in three dollars of savings to states, Deen said.
Call the American Lung Association Lung HelpLine at 1-800-LUNGUSA or 1-800-586-4872 or visit www.lungusa.org
"We can help a lot of people and Georgia at same time," Deen said. "We know that people want help quitting smoking and we know that it's very hard to quit, so we need to provide more options for people to quit."
Both Georgia and Tennessee received passing grades in the smoke-free air category, with state laws in place to restrict smoking in government and private workplaces, restaurants and bars. Alabama, on the other hand, does not restrict smoking in such places.
Signal Mountain mother Scottie Goodman Summerlin agreed that Tennessee needs to do more to help people stop smoking, but she said laws to restrict smoking in the state already have dramatically improved life for her and her two sons.
Summerlin calls herself a "regular mom" who volunteers with the American Lung Association to help raise awareness about secondhand smoke. She and her two sons have asthma and immediately notice when someone lights up at a ballpark or other public place.
"I feel like Tennessee has done a pretty good job so far; if you go to other places like Alabama or Nevada, you realize how much you take for granted," she said. "But I would like to see higher cigarette taxes. Studies show that the more you tax [cigarettes], the less people buy."