While California leads the nation in tobacco control policies, Turlock and most of Stanislaus County are still not making the grade according to the American Lung Association’s annual report.

The 16th annual report grades states and the federal government on policies to prevent and reduce tobacco use. California’s grades improved to the best in the nation thanks to strong policies across the state and the enactment of the new tobacco tax increase approved by voters.

“This year, California began reaping the financial and health benefits of an increased tobacco tax,” said Mark Johnson, board chair for the American Lung Association in California. “I’ve seen personally how effective it can be as one of my close relatives, a long-time smoker, finally quit the day the tobacco tax went into effect. Our family was so grateful for his lifestyle change and we’ve already seen a big improvement in his health.”

The hundreds of millions in increased tobacco taxes from Proposition 56 now flowing to critical state health and prevention programs lead to a big grade increase for California. The state received an A grade for funding for state tobacco prevention programs, up from an F in 2016. California’s grade for smoking cessation services also improved from an F to a C.

Despite a record-breaking year across the state, Modesto was the only city in Stanislaus County to raise their grade. Modesto went from a grade of F to a D.

The American Lung Association gave Stanislaus County cities D and F grades for implementing and continuing key tobacco control policies. The report gave Turlock, Hughson and Riverbank D grades, and Ceres, Waterford, Patterson, Newman, Oakdale and unincorporated areas of the county all had F grades.

Highlights from this year’s report include:

— A record number of 10 communities improved their overall grade to an A from last year

— California now has a total of 31 communities with an overall A grade

— Seventeen fewer communities received an overall F grade compared to last year

However, half of California’s population still live in communities scoring a D or F. This includes nearly half of the 10 most populous cities in the state.

“Smoking rates continue to decline in California, yet tobacco use remains the state’s leading cause of preventable death and disease, killing nearly 40,000 Californians each year,” said Vanessa Marvin, vice president, public policy and advocacy for the American Lung Association in California. “Tobacco use is a serious addiction, and the fact that 11 percent of California adults still smoke highlights how much work remains to be done in our communities to prevent and reduce tobacco use.”