Missouri and Kansas are about as far from the head of the class as they can get in terms of preventing harm from tobacco use, according to the American Lung Association’s 2018 report cards.
And some of the proposed remedies, like big tax hikes on tobacco products, could be about as popular as summer school.
For the second straight year, both states were at or near the bottom nationally, when the score cards were released this month. Missouri got four F’s and a D and Kansas got four F’s and an A.
The lung association recommended Kansas cover more smoking cessation methods under its Medicaid program, Missouri enact a statewide ban on smoking in public places and both states increase funding for tobacco prevention, hike tobacco taxes and raise the legal age to purchase to 21.
“Missouri elected officials must act to implement these proven policies, which will prevent tobacco-caused death and disease, and help keep our lungs healthy,” said Leah Martin, the director of tobacco control and advocacy for the association’s Missouri branch.
More than 11,000 Missourians die every year from tobacco-related illnesses.
The only bright spots on the report cards were an A for Kansas’ statewide smoking ban and a D — better than an F — for Missouri’s Medicaid-covered smoking cessation options.
Ashley Ray, the association’s manager of tobacco control and lung health in Kansas and Kansas City, said one of the quickest ways for both states to bring their grades up would be to hike their tobacco taxes.
At 17 cents per pack, Missouri’s cigarette tax is the lowest in the country, according to the nonprofit Tax Foundation. Virginia is next at 30 cents per pack.
Kansas is at $1.29 a pack, after the legislature approved a 50 cent increase in 2015. But it’s still below the national average of $1.68 per pack. New York is tops at $4.35.
The higher the tax, the greater the deterrent to smoking, according to the lung association.
“Any significant increase in that tax rate will help increase those grades,” Ray said.
That can be a tough sell in two states entirely controlled by Republicans. In past years tobacco tax hikes have been opposed not just by tobacco manufacturers, but also by anti-tax groups that have more influence in red states.
But Kansas Rep. Steven Johnson, a Republican from Assaria who is chairman of the House Taxation Committee, said he sees a possible path forward for a cigarette tax hike this year. The legislature needs money to shore up the state budget and fulfill a Kansas Supreme Court decision on education funding.
Johnson said lawmakers might view tobacco taxes as the best option for getting it.
“Any tax increase I think is a hard lift this year following the one on income (taxes) in ’17 and the one on sales (taxes) in ’15,” Johnson said. “Nonetheless, I think tobacco brings different constituent groups that support it, which brings the possibility.”
It’s less likely in Missouri, where voters have denied four cigarette tax hike campaigns since 2002, including two ballot questions last year.
A bill in the Missouri legislature, sponsored by Springfield Republican Rep. Curtis Trent, would allow cities and counties to enact their own tobacco taxes. That’s currently banned under state law.
A statewide smoking ban is also unlikely this year. Although most big cities in Missouri have one, Ray said some business owners in rural areas still fear it would hurt their bottom line.
“We now have data from this going on for several years showing that’s actually not true and most of the population would actually like to go to a smoke-free restaurant,” Ray said.
Successful campaigns to raise the legal purchase age, called “Tobacco 21,” are spreading from city to city in both states, with the backing of groups like the Greater Kansas City Chamber of Commerce.
Ray said that’s part of an incremental strategy to raise the purchase age to 21 statewide. Only two states, Hawaii and California, have done that so far.
“That’s to gain as much support as we can at the local level to have a strong push at the state level,” Ray said.