When I was 12 years old in 1966, my father died of a heart attack caused by cigarette smoking.

He was 43 and left behind my mother and five children. Fortunately, since 1966, thanks to strong actions taken by the federal and many state governments, smoking and smoking-induced diseases and deaths have declined substantially.

Sad to say, however, there is one state where progress in this area has been painfully slow, and this would be Missouri.

At 17 cents per pack, the Missouri cigarette tax is easily the lowest in the nation — less than 10% of the national state average of $1.76 per pack. In addition, despite receiving about $2.9 billion in payments since 2001 from a lawsuit against the major tobacco companies, Missouri spends almost nothing on tobacco control. As Missouri has no significant stake in the tobacco/cigarette industry, one might wonder why? The answer seems surprisingly simple.

In Missouri, nearly all prominent politicians accept campaign cash from tobacco companies and retailers. At the top of this list we find Gov. Mike Parson, who has accepted about $179,000 during his career. In a distant but still strong second place, we find Attorney General Eric Schmitt, at around $109,000. The Missouri Senate has 34 members. Led by Jamilah Nasheed ($35,200) and Bob Onder ($30,850), we find that 33 of the 34 accept money from tobacco interests. Closer to home, state Sen. Bill White, R-Joplin, has accepted $3,250 in tobacco money during his career.

The results:

• Over the past 10 years, the adult smoking rate in Missouri has averaged 22.8% — eighth-highest in the nation.

• In 2016, the Missouri lung cancer death rate was 48.0 per 100,000 population — ninth-highest in the nation.

• In 2016, the Missouri Heart Disease Death Rate was 192.1 per 100,000 population — ninth-highest in the nation.

• In Missouri, nearly twice as many women die from lung cancer (30,061 since 2000) than breast cancer (15,972 since 2000).

Equally disheartening is the fact Missouri is making no progress in reducing smoking-induced deaths. The annual smoking-induced death toll has averaged more than 11,000 since the start of the 21st century.

A primary tool at the disposal of the governor/Legislature is the cigarette tax. Increasing the cigarette tax raises cigarette prices, which deters smoking (particularly among teenagers) and provides revenues for tobacco control and other needed services.

In addition to being lowest in the nation, the Missouri cigarette tax is substantially below our bordering states. Oklahoma is at $2.03 per pack. Even major tobacco producer Kentucky is $1.10 per pack.

Think taxes only increase? The Missouri cigarette tax began in 1956 at 2 cents per pack. Adjusted for inflation, however, our cigarette tax is now 1.8 cents per pack — the all-time low.

Perhaps the most ill-informed and tiresome argument made by tobacco proponents goes something like “the government really wants you to smoke because government is addicted to the revenue” that cigarette taxes generate. In 2019, the Missouri cigarette tax and other tobacco products taxes yielded $94.8 million, accounting for one-half percent of the state operating budget excluding federal funds. Furthermore, my estimate is that in 2019 the Missouri Medicaid program spent $296 million of state money to treat smoking-related illness versus the $73 million the cigarette tax generates. Smoking is a net drain to the state treasury.

The governor and Legislature have the power to enact major improvements on this front without radical policy changes. Under the Hancock Amendment, they may increase revenues by about $100 million annually without a public vote. If you prefer a state that prioritizes public health over tobacco profits, let’s suggest the governor/Legislature support:

• Increasing the cigarette tax by about 20 cents a year until an appropriate level is attained. Each 20-cent increase would generate $85 million in additional revenue and would not violate the Hancock Amendment. For instance, a Missouri cigarette tax of $1 would increase revenues by $350 million a year and would remain well below the national average and below our primary neighboring states.

• Enact legislation that would maximize revenues from the Master Settlement Agreement lawsuit and allocate a greater share to tobacco control efforts and address the “vaping” situation.

Missouri’s performance in this area has been abysmal.

Tom Kruckemeyer served as chief economist for the Missouri Division of Budget & Planning from 1978-2004 and was chief economist for the Missouri Budget Project from 2005-2018.

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