AUGUSTA (AP) — Maine continued to slip in an annual tobacco-use report card issued by a health group, as it went from B to D in its efforts to help people to quit smoking.

In grades announced Wednesday, the American Lung Association gave Maine an A for its work to promote smoke-free air, a C for the impact of its cigarette tax on smoking efforts, but a D for tobacco prevention control and spending. All three of those grades are the same as they were the previous year.

But Maine slipped from B to D for tobacco-cessation spending, due to the elimination of state Medicaid funding for medications to help people stop smoking.

The overall grades represent a decline from Maine’s straight-A report given several years ago.