Data released by the Centers for Disease Control and Prevention last week show that between 2005 and 2013, the percentage of U.S. adults who smoked declined from almost 21 percent to slightly less than 18 percent.
That’s the lowest percentage since the CDC began keeping tobacco use records in 1965.
Similar data collected by the Kansas Department of Health and Environment put the state’s 2013 smoking rate at 20 percent – two percentage points higher than the national average.
In Missouri, the adult smoking rate is even higher. A report earlier this year by the American Lung Association said the percentage of Missouri adults who smoke stood at 23.9 percent. About 11,000 adults die each year in Missouri from their own smoking, according to the Campaign for Tobacco-Free Kids.
“We need to do better,” says Linda DeCoursey, executive director with the Tobacco Free Kansas Coalition advocacy group. “As a state, we haven’t done a very good job when it comes to putting money toward tobacco use prevention.”
In the current fiscal year, which began July 1, Kansas officials expect to spend about $950,000 on tobacco use prevention programs. In Missouri, which has more than twice the population of Kansas, total funding for state tobacco control programs in fiscal 2014 was $2.2 million.
“That’s ‘master settlement’ money,” DeCoursey says, referring to payments tied to Kansas’ 1999 settlement with the nation’s four largest tobacco companies. “It goes straight to KDHE, which uses it to fund some community-level grants. And that’s fine, that’s good, but it’s not enough.”
Typically, Kansas receives between $50 million and $60 million in master settlement payments each year. Most of the money is used to support programs that promote parenting skills and early childhood development.
Missouri receives about $130 million annually from the tobacco settlement. (In 2013, an arbitration panel ordered Missouri to refund $70 million for its alleged failure to diligently enforce state tobacco laws in 2003. A St. Louis judge later found that ruling to be “clearly erroneous” and restored $50 million of the $70 million.)
According to the CDC, Kansas should be spending at least $20 million – closer to $28 million, preferably – on its tobacco use prevention efforts. Missouri should be spending about $73.2 million.
“We’ve never had a comprehensive prevention program in Kansas because we’ve never had access to that kind of money,” DeCoursey says. “Until we do, we can expect Kansas’ smoking rates to be above most other states.”
Tracy Russell, tobacco prevention manager at the American Heart Association’s office in Overland Park, is leading a coalition of health care groups that hopes to convince lawmakers to significantly increase state spending on prevention efforts.
“We know exactly what works when it comes to bringing down a state’s smoking rates,” Russell says. “There needs to be a Clean Indoor Air Act, an impact on the cost of the product and adequate funding for effective prevention programs.”
Kansas, she says, has a statewide ban on indoor smoking, also known as the Clean Indoor Air Act.
“That’s one out of three,” she says.
The coalition, Russell says, is likely to propose an increase in the state’s cigarette tax, using the increase in revenue to underwrite a comprehensive prevention effort.
“We’re 36th in the country at 79 cents (per pack),” she says, referring to the state’s cigarette tax. She declined to say how much of an increase the group will propose.
The coalition, called Kansans for a Healthier Future, is expected to announce its membership and advocacy goals later this month, Russell says.
A portion of the coalition’s efforts are underwritten by a $200,000 grant from the Kansas Health Foundation.
“It is not surprising that Kansas is falling behind the nation in addressing tobacco use,” says Jeff Willett, vice president of programs for the Kansas Health Foundation, which is the primary funder of the Kansas Health Institute, the parent organization of the editorially independent KHI News Service.
“Last year, Kansas government received over $150 million through tobacco taxes and payments from the tobacco companies,” he says. “Unfortunately, the state invested less than 1 percent of that revenue in addressing the problem. It is time for Kansas to address this critical health and economic issue.”
Historically, legislators have resisted increasing the state’s cigarette tax due to concerns that convenience stores along the Missouri and Nebraska borders would lose sales.
Cigarette taxes in Missouri and Nebraska, at 17 cents and 64 cents per pack respectively, are lower than Kansas’ tax.
Missouri’s tax is the lowest in the nation.
Per-pack taxes in Oklahoma and Colorado, at $1.03 and 84 cents respectively, are higher than the Kansas tax.
The CDC report is part of the agency’s ongoing assessment of its Healthy People 2020 campaign, which includes a target of lowering the nation’s smoking rate to 12 percent or less.
“There is encouraging news in this study, but we still have much more work to do to help people quit,” Dr. Tim McAfee, director of the CDC’s Office on Smoking and Health, said in a prepared statement.
Other findings cited in the report:
• Cigarette use among adults above the federal poverty line went from roughly 21 percent in 2005 to slightly more than 16 percent in 2013. For those living below the poverty line, cigarette use remained steady: from almost 30 percent in 2005 to 29 percent in 2013.
• In 2013, people who reported having a disability were more likely to smoke than those who did not have a disability, at 23 percent and 17 percent respectively.
• From 2005 to 2013, the percentage of adult smokers who smoked 30 or more cigarettes per day fell from 13 percent to 7 percent.
Smoking is the leading preventable cause of disease and death in the United States, killing more than 480,000 Americans annually.
Tobacco use was a listed as a contributing factor in 3,466 deaths in Kansas last year.
