The federal government has repeatedly failed to take action to protect youth from flavored tobacco products, according to a new report by the American Lung Association (ALA).

The ALA’s State of Tobacco Control Report gave a failing grade to the Food and Drug Administration on its regulation of tobacco products for the fourth consecutive year. A key factor in the grade was the Trump Administration’s decision to exempt menthol and tobacco-flavored e-cigarettes from its policy to ban cartridge-based e-cigarette flavors, CNN reports.

“In 2020, the American Lung Association urges the federal government to implement proven tobacco control policies and help us end the youth vaping epidemic,” ALA National President and CEO Harold P. Wimmer said in a news release. “While the American Lung Association recognizes the federal government with an A grade for passage of a strong federal Tobacco 21 law, it also earns an F for its failure to comprehensively oversee tobacco products. Without meaningful actions by the federal government, the health and the future of our nation’s children are being compromised.”