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NewsOctober 22, 2006

KANSAS CITY, Mo. -- Ron Fields is sensitive to the annoyance of second-hand smoke. Cigarettes are banned in both the restaurant he manages and his home. Yet he continues to light up -- stepping outside to do so several times a day, even in brisk winds and chilly weather...

DAVID A. LIEB ~ The Associated Press

KANSAS CITY, Mo. -- Ron Fields is sensitive to the annoyance of second-hand smoke. Cigarettes are banned in both the restaurant he manages and his home. Yet he continues to light up -- stepping outside to do so several times a day, even in brisk winds and chilly weather.

"I make a choice that I smoke, and I fully expect to pay the health-care cost," said Fields, 45, who has puffed cigarettes for at least half his life. "So why should I pay a higher tax?"

Like many smokers, Fields is outraged by a Nov. 7 ballot measure that would more than quintuple Missouri's cigarette tax -- taking it from the nation's second-lowest rate of 17 cents a pack to a 97-cent tax nearer the national average. Missouri taxes on other tobacco products, such as cigars and chewing tobacco, would triple.

If approved by voters, the tax increase would kick in Jan. 1. And the revenue -- estimated at $351 million to $499 million annually -- would be used to increase state payments to health-care providers, expand government health-care coverage to low- and middle-income Missourians, and significantly enlarge the state's anti-tobacco efforts.

Over the course of a week, The Associated Press talked to smokers shivering outside suburban St. Louis office buildings, huddled around ashtrays on the Springfield campus of Missouri State University and fuming on the sidewalks of Kansas City.

With few exceptions -- and not surprisingly -- smokers vowed to vote against proposed Constitutional Amendment 3. They aired complaints of tax discrimination by do-gooder nonsmokers and distrust of how the government would spend their tax money. Many said they would keep on smoking, even if the price went up.

Yet research cited by advocates of the ballot measure indicates some smokers will stop if the tax is raised. And if that happens, both smokers and secondhand-smoke inhalers will be healthier, saving not only lives but also millions of dollars on health-care costs, the research says.

"I've seen the results of tobacco use in our state and in my patients, and I think we need to do something about it," said Dr. Jim Blaine, a family practitioner in Springfield who cut his workload in half for the final month before the election so he could volunteer as a spokesman for the ballot measure's sponsor, the Committee for a Healthy Future.

"I see a lot of heart disease as a result of tobacco use," Blaine said. "Not a week goes by that I don't diagnose a cancer that's related. Certainly I've seen a significant number of strokes, particularly in the emergency department. And it's almost exclusively the only cause of emphysema."

The Campaign for Tobacco-Free Kids cites more than a half-dozen studies over a decade while concluding that every 10 percent increase in the price of cigarettes will reduce overall cigarette consumption by 3 percent to 5 percent and reduce the number of children who smoke by 6 percent or 7 percent.

The organization places the average retail price of a pack of cigarettes in Missouri at $3.43. If voters approve Amendment 3 and the full tax hike is passed on to consumers, the average price of cigarettes would rise to $4.23 a pack -- a more than 20 percent increase.

Following the formula embraced by researchers, that would mean more than 100,000 of Missouri's roughly 1 million smokers would give up the habit if the tax increase is approved.

Darnell Kincade, 46, of St. Louis, might be one of them. Although he vows to vote against the tax, "If the price goes up, I'm going to stop" -- cold turkey, he said.

But fellow St. Louis resident Zachary Smith, 47, said quitting was out of the question for him.

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"When you're hooked on something, regardless of the price, you'll keep buying it," he said.

Other smokers suggested they might change -- but not quit -- their habits.

"It might increase the chance of me buying cartons of cigarettes instead of packs," thus getting a bulk discount on the price, said Adam Anderson, 22, of Columbia, a senior at Missouri State University.

Cahokia, Ill., resident Milton J. Stover, 47, said he started rolling his own cigarettes to save money when Illinois raised its cigarette tax, now at 98 cents a pack.

"I should've (quit), but I didn't," Stover said. "I enjoy smoking."

Illinois is one 42 states that have passed or implemented higher cigarette taxes since 2002.

That was the same year Missouri voters narrowly defeated a ballot measure that would have increased the cigarette tax to 72 cents a pack. The 2002 measure would have directed money toward health care programs and raised payments to health care providers. But a smaller portion would have gone to anti-tobacco efforts than under this year's proposal. And some of that money also would have gone to life sciences research and early childhood programs.

Political scientists attributed part of the 2002 failure to a general aversion to tax increases among Missourians and a general distrust of how the government would spend the money.

The Committee for a Healthy Future is proposing a constitutional amendment his time, instead of merely a change in state law -- a difference supporters hope will help assure voters the money will be spent as intended. The amendment spells out the precise percentages of money that are to go each beneficiary.

But some smokers remain skeptical.

Missouri State University economics instructor John Buchanan said he understands the logic of the proposed tax increase. But that doesn't necessarily make him support it.

"Cigarettes are not a necessity. If you're going to tax something, you tax something that's not a necessity," Buchanan said while snuffing out a cigarette before rushing into a classroom building. "I'd vote for it if I knew where the money was going."

Fields, the manager of the Harvey House restaurant at Kansas City's Union Station, said he smokes about a half pack of cigarettes a day -- down from two packs a day just a year or so ago. He chose to cut back, but doesn't want a majority vote of nonsmokers choosing how much he should pay.

"We have respect for nonsmokers," Fields said, "but don't take the self-righteous attitude and beat me over the head with it. It's my choice."

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