Petroleum-powered transportation costs society $37 billion each year for 10 U.S. states when taking health and climate damages into account, according to a new report released by the American Lung Association.

An electric vehicle program would save billions annually, the report said.

The study, released Thursday, examines the health and climate impacts caused by vehicle pollution in California and nine other states that have adopted zero-emission vehicle (ZEV) programs.

The report broke down the costs of smog climate pollution caused by passenger vehicles in 10 states with ZEV programs. California’s costs were the highest of the 10 states, estimated at $15 billion in 2015.

“Clean Air Future: Health and Climate Benefits of Zero Emission Vehicles” looks at how zero-emission vehicles would clean the air and curb dangerous climate and health impacts.

Every year, passenger vehicle pollution costs the states with ZEV programs nearly $24 billion in health costs.

The full report can be found on their website.