U.S. leaders failed to take meaningful steps to reduce smoking over the past year, with a tobacco regulation bill stalling in Congress and a global treaty gathering dust, a major health group said on Tuesday.

In its annual report on U.S. tobacco control efforts, the American Lung Association criticized the Bush administration, Congress and various state governments for inaction on a range of measures to curb smoking.

The report gave federal efforts mostly failing grades.

It noted that the House of Representatives passed a bill in July that would give the U.S. Food and Drug Administration broad authority to regulate cigarettes and other tobacco products, but the Senate did not pass it. The bill must start over in the new Congress.

The White House expressed "serious concerns" about the bill and threatened a presidential veto. Some tobacco companies opposed it, but it was supported by the largest U.S. cigarette maker, Philip Morris, a unit of Altria Group Inc.

The Bush administration again did not submit an international tobacco control treaty to the Senate for ratification even though the United States previously signed the accord, the report said.

The group also said the 39-cent per pack federal cigarette tax remains too low, citing evidence that consumption of cigarettes decreases as their cost increases.

The American Lung Association also criticized federal officials for failing to require state Medicaid programs to cover smoking cessation treatments for people covered by the health insurance program for the poor and disabled.

"The federal government's grades this year are abysmal," Paul Billings of the association said in a conference call with reporters.

Individual states did not escape the wrath of the group, particularly Alabama, Kentucky, Missouri, North Carolina, South Carolina, Virginia and West Virginia. The report said Hawaii, Maine, Massachusetts and Rhode Island did the best job.

States' efforts were assessed based on steps such as laws barring workplace smoking, funding levels for state tobacco control measures, covering tobacco cessation treatments in public health insurance programs and state cigarette taxes.

Of the 50 states, only Alaska and Delaware were given top marks for funding tobacco control programs at 80 percent or more of the levels recommended by the U.S. Centers for Disease Control and Prevention. The report praised North Dakota voters for passing a ballot initiative to make that state fund its program at the level urged by the CDC.

Massachusetts and New York were the only states to raise cigarette excise taxes in 2008, according to the report. New York had the nation's highest cigarette tax at $2.75 per pack, with South Carolina having the lowest, at 7 cents per pack.

The CDC said in November that the number of U.S. adults who smoke dropped below 20 percent in 2007 for the first time on record but cigarettes still kill almost half a million Americans a year. Health experts call tobacco use the leading preventable cause of death in the United States.

Click here to read the full report.