The national Campaign for Tobacco-Free Youth ranks Missouri dead last in spending on programs preventing young people from smoking. Missouri, Michigan, South Carolina, Tennessee, New Hampshire and the District of Columbia are at the bottom of the organization’s list. A State Health Department spokesman acknowledges none of the money from the national tobacco settlement has been used for prevention. The state has gotten bad reviews from other organizations, too. The National Women’s Law Center and the Center for Women’s Health and the American Lung Association. All have given the state failing grades for reducing or preventing smoking by young people and women.