Four F's and a C. Those were the grades Missouri received this year in the American Lung Association’s annual State of Tobacco Control report, which urged the state to strengthen its tobacco control policies.
One major sticking point? Missouri currently has the lowest cigarette tax in the country — 17 cents per pack of 20 cigarettes, compared to the national average of $1.91 per pack.
“The tax has kind of been something that’s haunted us for a long time,” said Laura Turner, the Missouri and Arkansas director of advocacy for the American Lung Association. “So I’m no stranger to that.”
The state's low cigarette taxes don’t just affect purchasing decisions of Missouri residents. Some out-of-state customers also come to Missouri to take advantage of the cheaper tobacco. In fact, some businesses near state lines directly advertise to travelers.
“I mean, when you cross the border, you see that it’s advertised,” Turner said. “So I’m certain that it’s a draw — because I know it’s from all different sides.”
Toni McCullough, the manager of Discount Smokes and Liquor in the Missouri-Arkansas border town of Pineville, knows this firsthand.
“We get a lot of customers from Arkansas and Oklahoma,” McCullough said. “A lot of people drive over the line to get (cigarettes).”
Even as new highways reroute some traffic, McCullough still sees a steady stream of customers — particularly truckers — who stop in Missouri specifically for lower-priced tobacco.
"We still have (drivers) that will travel mostly through here," she said, "just because they know we’re cheaper."
Arkansas has higher tobacco taxes. The state imposes an excise tax on products considered harmful to public health. Arkansas levies a cigarette tax of $1.15 per pack, and other tobacco products are taxed at 68% of the manufacturer’s selling price.
Missouri not only ranks lowest in cigarette taxes, but it also lags other states in funding tobacco cessation efforts.
“We track the state tobacco-related revenue,” Turner said. “The most recent data we have is $219.6 million in state tobacco-related revenue. And we like to contrast that with the amount that goes to prevention and cessation. So we get about $5 million in that amount.”
The U.S. Centers for Disease Control and Prevention recommends Missouri spend about $73 million on tobacco cessation programs, Turner said, and the state contributes only about 7% of that amount.
She said efforts to raise the tax and generate more funding have met roadblocks.
“There was work on a ballot initiative to raise the tax, and that initiative failed,” Turner said. “But to get a tax significant enough to have a public health benefit — which is usually over a dollar more than what it currently is — in Missouri, the Hancock Amendment requires that it go to a ballot initiative. It can’t be done legislatively.”
The time and expenses required to put a new tax before Missouri voters have proven prohibitive, Turner said.
“Mainly, the money isn’t there to get it on the ballot,” she said. “Unfortunately, that’s been the big barrier.”
