And this comes on the heels of a December report, in which a number of health organizations ranked Georgia 49th among states on programs to prevent children from smoking and helping smokers quit. Georgia has received bad grades and ranked poorly for the past several years.

“No matter how you look at it, Georgia is at the bottom of the heap when you are looking at states trying to do something to prevent the leading cause of preventable death,” said Dr. Michael Eriksen, vice president for research at Georgia State University and a tobacco control expert. “Georgia is pathetic compared to other neighboring states and the rest of the country. It sounds harsh but it’s true.”

Georgia is receiving about $150 million in tobacco settlement funds for the 2020 fiscal year. Most of the money goes toward Medicaid, the program that pays for medical care for low-income residents. About $10 million goes toward cancer research and screening. On the whole, states will will spend less than 3% – $739.7 million – on tobacco prevention and cessation programs. In Georgia, that percentage is 0.7%, with $750,000 appropriated for the Georgia Tobacco Quit Line.

The American Lung Association, the Campaign for Tobacco-Free Kids and other organizations want to see more invested in prevention and cessation. But they are focusing this year on lobbying to raise cigarette taxes. Georgia has the third-lowest tax on cigarettes in the United States at 37 cents per pack. Only Missouri and Virginia have lower taxes. The national average is $1.81.

The Georgia Budget and Policy Institute says Georgia could raise $400 million annually by increasing the cigarette tax by at least $1 per pack.

State legislators are expected to once again debate whether to raise taxes on cigarettes – which was last increased in 2009.

For years, state Rep. Ron Stephens, R-Savannah, has proposed increasing the cigarette tax, saying it would deter new smokers and provide money for public health programs, which spend tens of millions of dollars a year on smoking-related illnesses. Though his bills have died in previous years, he plans to push the increased tax again this session.

Last year, Georgia House Speaker David Ralston moved to extinguish talk of a cigarette tax hike during the 2019 General Assembly session.

Ralston, a Republican from Blue Ridge, told The Atlanta Journal-Constitution last year he was always hesitant to suggest raising taxes, “even on that.”

Ralston and Stephens haven’t discussed the measure this year, and Ralston declined to comment.

The American Cancer Society’s lobbying arm in Georgia said raising the cigarette tax is its No. 1 priority. They also want to see a tax on vaping products.

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A Juul vape arranged for a photograph in Brooklyn, New York, on July 6, 2018. MUST CREDIT: Bloomberg photo by Gabby Jones

Andy Freeman, the Georgia Government Relations Director for the American Cancer Society Cancer Action Network, said the rising concern about teen vaping and a need for the state to generate more revenue makes this is a good year to do something.

Advocates also say increasing tobacco taxes is one of the most effective ways to reduce its use and prevent youth smoking. A 2017 study in the journal Epidemiology found that when the price of cigarettes increases by $1, there is a 20% increase in rates of quitting. The study, which examined the habits of 632 smokers, also found a $1 increase in price was linked to a 7% reduction in heavy smoking — 10 cigarettes or more a day.

In Georgia, 16.1% percent of adults smoke, down from 19.5% in 2008, according to the Centers for Disease Control and Prevention. Meanwhile, teen vaping has soared, and a recent outbreak of a mysterious lung disease linked to vaping, most by using THC-related or bootleg substances, has brought an onslaught of scrutiny and concern.

In the 2018 Georgia Department of Public Health’s Georgia Youth Tobacco Survey, one in four Georgia high school students said they had used e-cigarettes. Overall the report found 12.7% of high school students in Georgia smoke e-cigarettes. And, about 8% of high school students in Georgia reported that they were cigarette smokers.

Smoking, the nation’s leading cause of preventable death, takes an estimated 480,000 lives every year. In Georgia, 17,990 people will die from cancer this year, and 29.2% of cancer deaths are tobacco-related, according to the American Cancer Society.