2010, and the percent of tobacco smokers in the state has declined from 19% in that year to 12.4% in 2022, but an additional 6.8% use e-cigarettes. Virginia does have above average percentage of residents who receive annual immunizations, ranking sixteenth for yearly flu vaccinations. In 2008, Virginia became the first U.S. state to mandate the HPV vaccine for girls for school attendance, and 64.9% of adolescents have the vaccine. , 73.6% of Virginians had received a full COVID-19 vaccine. The Virginia Board of Health regulates health care facilities, and there are ninety hospitals in Virginia with a combined 17,706 hospital beds . Notable examples include Inova Fairfax Hospital, the largest hospital in the Washington Metropolitan Area, and the VCU Medical Center, located on the medical campus of Virginia Commonwealth University. The University of Virginia Medical Center, part of the University of Virginia Health System, is highly ranked in endocrinology according to U.S. News & World Report. Sentara Norfolk General Hospital, a teaching institution of Eastern Virginia Medical School, was the site of the first successful in-vitro fertilization program. Virginia has a ratio of 254.8 primary care physicians per 10,000 residents, the fifteenth worst rate nationally, and only 228.8 mental health providers per that number, the thirteenth worst nationwide. , the state's eight public mental health care facilities were 96% full, causing delays in admissions. Media The Hampton Roads area is the 44th-largest media market in the United States as ranked by Nielsen Media Research, while the Richmond-Petersburg area is 56th and Roanoke-Lynchburg is 71st . Northern Virginia is part of the much larger Washington, D.C. media market, which is the country's 9th-largest. There are 36 television stations in Virginia, representing each major U.S. network, part of 42 stations which serve Virginia viewers including those broadcasting from neighboring jurisdictions. According the Federal Communications Commission, 595 FCC-licensed FM radio stations broadcast in Virginia, with 239 such AM stations . The nationally available Public Broadcasting Service (PBS) is headquartered in Arlington. Independent PBS affiliates exist throughout Virginia, and the Arlington PBS member station WETA-TV produces programs such as the PBS NewsHour and Washington Week. The most circulated native newspapers in the Commonwealth are Norfolk's The Virginian-Pilot with around 132,000 subscribers, the Richmond Times-Dispatch with 86,219, and The Roanoke Times . USA Today, which is headquartered in McLean, has seen its daily subscription number decline significantly from over 500,000 in 2019 to just