It's not quite a failing grade — but you wouldn't want your teenager to come home with this mark either.

Canadian health advocates including the Lung Association, Canadian Cancer Society and Heart and Stroke Foundation have given the Saskatchewan government a D+ on its efforts to curb tobacco use.

"Saskatchewan has the highest youth smoking rate in Canada, which is nearly double the national average," said Donna Pasiechnik of the Canadian Cancer Society, in a release Tuesday. She went on to call the rates unacceptable.

According to the health groups, the report card and analysis was conducted by an independent tobacco control consultant. It found Saskatchewan was far behind the rest of the country.

"Other provinces have moved to ban smoking on outdoor playgrounds and parks, sports fields where kids gather. We simply don't believe tobacco should be used in these places where kids play," Pasiechnik said.

The Heart and Stroke foundation says the government has not kept up with new evidence. While the Lung Association is calling for a more aggressive strategy that will reduce the high use of tobacco in the province. The report card calls the government's efforts "listless".

"We have the smoking rates that are too high. We have public support. We have provinces moving forward on all of these measures. Why are we not?" Pasiechnik said.

The groups say Saskatchewan made around $275 million off of tobacco taxes, but only spent $450,000 on tobacco control.

Here's a look at how the province scored: