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Missouri ranks near bottom in anti-smoking efforts

This article first appeared in the St. Louis Beacon, Nov. 18, 2010 - WASHINGTON - Even though the state has one of the nation's highest smoking rates, Missouri ranks third from the bottom among the states in the amount it spends on programs to help smokers quit and prevent children from taking up the habit, a new study has found.

"Missouri has consistently ranked among the worst states in its funding of smoking prevention," says Vince Willmore, a vice president of the Campaign for Tobacco-Free Kids. "The problem is exacerbated because Missouri now has the lowest tobacco tax in the country" -- meaning that it costs less for people to smoke.

The study -- released Wednesday by the Tobacco-Free Kids Campaign along with the American Heart Association, American Cancer Society, the Cancer Action Network, American Lung Association and the Robert Wood Johnson Foundation -- reported that many states, squeezed by low revenue, have been cutting funding for anti-smoking programs, despite record revenue from the 1998 state tobacco settlement and state tobacco taxes.

For More Information

Read the CDC survey of smoking rates

Here's a state-by-state comparison of tobacco taxes

For example, Missouri is expected to collect about $245 million this year from the tobacco settlement and the state's 17 cents-a-pack tax on cigarettes, the report said. But the survey found that Missouri spends only about $60,000 a year on tobacco prevention and cessation programs -- a mere 0.1 percent of the sum recommended by such programs for the state by the U.S. Centers for Disease Control and Prevention.

Willmore told the Beacon that Missouri "has failed to take any of the steps in recent years that would lower smoking levels and, by doing so, lower health bills" -- such as raising the tobacco tax, stepping up funding of tobacco prevention programs and enacting laws to ban smoking in most workplaces, restaurants and bars.

Proponents of an increase in the tobacco-products tax -- facing stiff opposition from the state's tobacco lobby -- have failed to raise that tax at least twice in the Missouri legislature, in 2002 and 2006. A new effort is now being discussed, and former Missouri Gov. Bob Holden, who now runs the Holden Public Policy Forum at Webster University, supports the concept.

Holden told the Beacon that the state -- by keeping its tobacco tax so low and not spending more on anti-smoking programs -- was contributing to the increase in smoking rates, the adverse health impacts of smoking and the cost of state health programs.

"The single most important factor for discouraging young people from smoking is raising the cost of cigarettes," said Holden, who had tried unsuccessfully to convince the Legislature to raise the tobacco tax and step up anti-smoking programs during his term as governor from 2001-2005. "Raising the tobacco tax makes sense from a financial standpoint. If you are looking to control your budget, you need to reduce things like health-care costs -- and smoking clearly increases those health costs."

According to the Tobacco-Free Kids group, smoking claims the lives of about 9,500 Missourians a year and costs an estimated $2.1 billion in health care bills.

The CDC recently reported that the adult smoking rate in 2009 was 20.6 percent, virtually unchanged since 2004 when 20.9 percent of Americans smoked. In Missouri, the adult smoking rate is 23.1 percent -- fifth highest among the states -- and 18.9 percent of high school students smoke.

The Illinois adult smoking rate is 18.6 percent, which is lower than the national average. Unlike Missouri, Illinois ranks closer to the average in state spending on smoking prevention programs ($9.5 million a year, ranking 35th among states) and in state tobacco tax, which is 98 cents a pack. The average state tobacco tax is $1.45 a pack, and New York state ranks highest at $4.45 a pack.

With the U.S. adult smoking rate stalled in recent years after decades of decline, the report from the coalition of health groups warns that the campaign against smoking is also threatening to stall unless states spend more on programs to prevent and stop smoking.

The report also calls on states to increase tobacco taxes and enact smoke-free laws that apply to all workplaces, restaurants and bars.

"States have a responsibility to prevent people from starting to smoke and to ensure that all smokers have easy access to cessation treatments and services as the human and financial toll of tobacco continues to rise," said Charles D. Connor, American Lung Association president and CEO, in a statement. "Preventing kids from smoking and helping smokers quit saves lives and money."

Rob Koenig is an award-winning journalist and author. He worked at the STL Beacon until 2013.