(Undated) -- The commonwealth is receiving poor marks for its tobacco control efforts. The American Lung Association's annual report gives the state two "Cs" -- for smokefree air laws and the cigarette tax -- and two "Fs" -- for funding tobacco prevention and control as well as quit smoking programs. Pennsylvania's grades were unchanged from last year. Thomas Carr, the study's lead author, says the state gets low marks, in part, because its current indoor smoking ban doesn't go far enough. "Some restaurants and bars and casinos as well are not smoke-free. What really needs to happen is the legislature needs to pass a law banning smoking in restaurants and bars and casinos to protect those workers from secondhand smoke," Carr says. Carr adds most states have room for improvement. The Lung Association says tobacco use costs the nation $193 billion anually in healthcare costs and lost productivity.