CARSON CITY, Nev. (AP) - Nevada is dead last among all states in efforts to help women quit smoking, according to an advocacy groups's national report card on women and tobacco.

While last, Nevada wasn't alone: 38 other states also flunked a survey that gauged smoking rates and cessation programs, the National Women's Law Center said Tuesday. Smoking is the primary cause of lung cancer, which kills more women than any other kind of cancer. "Every program that focuses on women's health should definitely make smoking cessation or smoking prevention among the highest priorities," said Virginia Ernster, an adviser to the law center and an editor of the 2001 surgeon general's report on women and smoking. The survey shows that 28.5 percent of Nevada's adult women smoke, compared with a national rate of about 21 percent. However, among girls in grades 9-12 nationally, almost 28 percent smoke compared with Nevada's rate of just under 26 percent; and among pregnant women, the national average for smokers is just over 12 percent while Nevada is at 11 percent. Only Utah meets the 2010 national goal of 12 percent or fewer women smoking. The report was released two years after the surgeon general issued a report calling smoking a leading killer of women. The group says state governments are failing to adequately address the problem. Nationally, about 20 percent of women smoke, compared with roughly 25 percent of men. But women smokers face unique risks: menstrual irregularities and earlier menopause, infertility; bone-thinning osteoporosis; arthritis; cervical cancer; and dangerous blood clots if they use birth control pills. Nevada's lowest marks came for having minimal or no policies on private insurance smoking cessation coverage, second-hand smoke restrictions or youth access restrictions. The report also said the state had weak policies on tobacco prevention funding and tobacco sales to minors. Another low mark was for cigarette excise taxes - although the state Legislature just imposed a major increase on such taxes. The report gave the state high marks for a telephone "quitline," pregnancy-specific counseling on the quitline, and Medicaid coverage of pregnancy-specific counseling.

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