Health groups want to raise cigarette tax

If approved by voters, the increase would raise $351 million the first year.

ST. LOUIS -- A coalition of health groups is spearheading a citizen initiative to raise the state's cigarette tax by 80 cents a pack to pay for prevention and cessation programs and health care for those harmed by tobacco.

The Committee for a Healthy Future wants to place the tax increase on the November 2006 election ballot. If approved by voters, the increased tax would raise an estimated $351 million in the first year, said Lori Pickens, senior executive of American Lung Association of Missouri, and committee spokeswoman.

The group's petition for a proposed constitutional amendment was filed late Friday with the Secretary of State's office.

"This has been a long time coming," she said. "Missouri, of all states, needs it more than anybody. (Smoking) is costing Missouri taxpayers and it's hurting a lot of families."

Missouri's current cigarette tax rate of 17 cents a pack is second-lowest in the nation, after South Carolina, which is 7 cents a pack. Missouri has one of the highest smoking rates in the country and is the least funded for smoking prevention, Pickens said.

Every day, she said, 28 Missourians die from smoking-related diseases. Nearly 90 percent of the people who smoke begin their habit as teenagers.

Missouri's share of settlement money from a 1998 agreement between tobacco manufacturers and 46 states was aimed at addressing tobacco prevention.

But the money was "squandered, in our opinion," Pickens said, to plug budget gaps under the administrations of Govs. Bob Holden and Matt Blunt.

Janet Wilson, chief of the state's health promotion unit, said the state has relied exclusively on federal grants for tobacco prevention, which this year was reduced 6 percent to $900,000.

"There's solid evidence that prevention strategies are effective, including increasing the price of tobacco products," Wilson said.

Blunt's spokesman, Spence Jackson, said Friday if the proposal garners the required number of signatures, it would go before the people as a ballot initiative.

However, Blunt doesn't support it in principal, and "opposes any effort to increase the tax burden on Missourians," Jackson said.

Besides the American Lung Association, the coalition also includes representatives from the American Cancer Society, American Heart Association and other health groups in the state.

The proposal, which needs nearly 150,000 signatures to get on the ballot, would impose a tax of 4 cents per cigarette -- or 80 cents a pack -- as well as a 20 percent tax on non-cigarette tobacco products.

It would create a "Healthy Future Trust Fund" provision in the state constitution requiring the tax revenue to be spent on smoking prevention and cessation, and disease management for uninsured Missourians who suffer from chronic, smoking-related illnesses such as lung cancer, heart disease and emphysema.

Persons with an annual household income of less than 200 percent of the federal poverty level would be given "health access cards" for outpatient visits, pharmacy and other services to avoid debilitating illness which could force them onto Medicaid. Amounts would vary.

Pickens said 54 percent of the trust fund would beef up Medicaid reimbursement rates to attract doctors and providers who won't accept the current Medicaid reimbursement rate.

The higher reimbursement rate could be especially critical for rural Missourians who currently have little or no access to care, she said.

The proposal also calls for strict controls on use of the trust fund. Annual audits would ensure no fund money would be diverted to other uses, and that no current health care funding gets replaced by the new cigarette tax revenues.

Pickens said those controls and focused spending differentiate this plan from a tobacco-tax proposal rejected by voters in November 2002.

Voters rejected that tax by about 51 percent -- a 30,509 vote margin of defeat out of nearly 1.8 million votes cast.

If Missouri does increase its cigarette tax, it will be riding an "amazing" national trend that has seen more than 55 increases since 2002, said Aaron Doeppers, Midwest regional advocate for the Washington, D.C.-based Campaign for Tobacco-Free Kids. The idea is gaining popularity with states that need new revenue sources while it cuts state expenditures on tobacco-related illness as smoking rates decrease.

"The cost savings in heart disease, cancer and diabetes is pretty staggering," he said.

Kentucky, a tobacco state, used to have the lowest cigarette tax at 3 cents a pack, but increased it June 1 to 30 cents a pack. Virginia, headquarters for the nation's largest cigarette maker, Philip Morris USA, recently increased its cigarette tax by 10 cents, to 30 cents a pack, Doeppers said.

If Missourians approve the higher cigarette tax increase, its new 97-cents-per-pack tax would rank 22nd nationally. The national average is 91.7 cents per pack.