Since 1964, 20 million Americans have died from smoking according to the American Lung Association.
Wednesday it announced grades for all cities and counties in California and it says the state is falling behind.
Both Santa Barbara and San Luis Obispo counties received a "B" grade. The grades are based on whether or not laws are protecting residents from the dangers of smoking.
In California more than 60 percent of cities received an "F" for their overall tobacco grade. According to the American Lung Association 500 thousand people a year die from smoking. 36 thousand of those people are Californians.
In San Luis Obispo County, San Luis Obispo received the highest combined grade of a "B" for smoke free outdoor air, smoke free housing, and reducing tobacco sales.
Atascadero, Pismo Beach, and Paso Robles received the lowest grade of an "F".
"We have a good set of regulations with smoking in public places including restaurants, bars, sidewalks, parks, plazas and so forth," said Councilman John Ashbaugh. "We could do better, especially regulating second hand smoke in the indoor environment in some places in San Luis Obispo."
San Luis Obispo is also recognized by the association for being the first city in the world to eliminate smoking in all public buildings in 1990.
The American Lung Association assigns grades each year. The state as a whole received an "A" for smoke free air and an "F" for funding tobacco prevention.
According to the association tobacco use remains the leading cause of preventable death and illness in the nation.