Research shows that tackling tobacco use requires a four-pronged approach: Tax it. Restrict it. Prevent it. Help people quit it.

Pennsylvania and New Jersey are strong on the taxation piece, but both states could do more on the other prongs, according to a new report by the American Cancer Society's Cancer Action Network.

"On tobacco control, I'd say we have a mixed bag. There is certainly room for improvement," said Diane Phillips, who directs the network's advocacy and lobbying efforts in the Keystone State.

Brian Shott, her counterpart in the Garden State, noted that last month, New Jersey became only the third state in the nation to raise to 21 the age at which smoking materials can be bought. Yet when it comes to funding tobacco prevention and cessation programs, "we are significantly lagging behind," he said.

The annual report, now in its 15th year, assesses all 50 states' anti-cancer laws and policies, including funding for cancer screening and age restrictions on indoor tanning. But much of the report is devoted to tobacco, because smoking is the nation's number one cause of preventable death and disability. In Pennsylvania, for example, tobacco use costs the state $6.38 billion in health-care expenses, and is linked to 28 percent of cancer deaths, the advocacy group Campaign for Tobacco-Free Kids estimates.

Here's how the Cancer Action Network says Pennsylvania and New Jersey measure up on comprehensive tobacco control:

  • Excise taxes. Both states impose a tax that is higher than the national average of $1.69 per pack of cigarettes. Pennsylvania tacks on $2.60 and New Jersey adds $2.70 per pack. Phillips said that last year, Pennsylvania also enacted a weight-based tax on smokeless tobacco products.
  • Smoke-free laws: Pennsylvania gets a middling rating because many restaurants and bars have been exempted from the overall ban on smoking in workplaces. (Philadelphia's separate law is tougher, but still has exemptions.) New Jersey gets a top rating, even though casinos are not required to be smoke-free.
  • Funding tobacco control programs: About $26.6 billion will flow to the 50 states this year from excise taxes and  the tobacco companies' master settlement agreement. But only one state — North Dakota — plans to fund smoking prevention and cessation programs at the level recommended by the U.S. Centers for Disease Control and Prevention. Pennsylvania will spend $13.9 million, about 10 percent of the CDC's recommended $140 million. New Jersey has appropriated a paltry $500,000 — although Shott said pending legislation with bipartisan support would raise the amount to $7 million a year beginning next July.
  • Medicaid coverage of tobacco cessation: In Pennsylvania, Medicaid, the insurance program for the poor, covers at least one type of counseling, and one approved medication, to help enrollees kick the habit. In New Jersey, traditional Medicaid doesn't cover any quitting assistance.