Group seeks added tax for tobacco use prevention, treatment

A Constitutional amendment proposal he hopes to see on the November ballot would raise taxes on cigarettes by 4 cents per cigarette, said Dr. Alan Chen of Dexter on Friday afternoon. Thus, a full pack of cigarettes would cost an added 80 cents, while a carton would cost another $8.

In addition, the effort would levy an added 20 percent tax on other tobacco products, like cigars, pipe tobacco and/or smokeless tobacco.

The amendment, if adopted by voters, would keep such taxes out of the General fund, but would instead would put revenue raised into a separate fund, hopefully immune from the desires of politicians to spend it on various non-tobacco-related projects.

"There are two purposes," Chen said Friday afternoon. "Number one is [to]] reduce smoking."

He said research on tobacco tax levels had indicated each 10 percent increase in the price of cigarettes sees an overall 4 percent reduction in cigarette consumption, with a 7 percent reduction in teenage cigarette consumption.

"Second, it [will] generate $351 million for promotion of cigarette [smoking] prevention," Chen said, "and also for the poor for [tobacco-related] medical care."

Information he made available from the Committee for a Healthy Future indicated the fund, as envisioned, would see 17.5 percent of the money generated, or an estimated $61 million per year to start, go into smoking reduction and cessation programs, while the other 82.5 percent, $290 million, would see use in reducing health care costs associated with tobacco use:

* Funding access to medically-necessary health care coverage programs and services for those living under 200 percent of the federal poverty limit ( $102 million)

* Increasing access to primary care and specialist physician services for the most needy ( $102 million)

* Ensuring necessary trauma care and hospital emergency room care for services provided to low-income and uninsured Missourians ($44 million)

* Providing additional funding for safety net clinics, such as community health centers ($38 million)

* Enhancing availability of emergency ambulance services provided to low-income Missourians ($4 million).

Chen agreed with the idea the added tax would generate reduced demand for, and thus reduced revenue from, tobacco products. He disagreed, however, with a suggestion that demand, and thus and revenue, would decline before the need for the health care-related funding would.

"The first purpose is to reduce smoking," Chen said, "and therefore they [at the state level] would not need that much money for future kids.

"And even if you don't reduce the smoking, you still have to take care of those people."

He emphasized the purpose of a Constitutional referendum was to take the tobacco tax money thus generated out of the general fund and away from politicians who would be likely to find uses other than the intended purpose. Chen acknowledged such a diversion was what had happened to the Tobacco Settlement money the state had received from the tobacco companies.

"Just like the tobacco settlement," Chen said. "That was bad."

According to the webpage http://www.tcsg.org/tobacco/settlement/t... Missouri was to receive up to $4.46 billion over the 25 years ending in 2025, or an average of $178 million per year.. But according to the webpage http://www.tobaccofreekids.org/reports/s..., the state was to have appropriated $22.2 million of the tobacco settlement funds received for tobacco cessation programs in fiscal year 2002.

But in 2002, then-Gov. Bob Holden cut all funding for tobacco cessation and prevention due to a budget shortfall. In FY2003 through FY2005, Missouri appropriated no money for tobacco use prevention. Consequently, Missouri has yet to spend any of its tobacco settlement funds on tobacco use prevention going all the way back to the initial payment.

The settlement payment in FY2004 went to the general fund -- as Chen said the proposed Constitutional amendment would specifically prohibit -- plus health care programs, and prescription drug programs for senior citizens. Also in FY2004, the Legislature passed a settlement carve-out to fund life-science business development in the state. The FY2005 settlement payment went to the state general fund with a portion specifically dedicated to life science research.

Other states, like neighboring Arkansas, went to the voters for dedication of the tobacco settlement funds to various programs, including a trust fund set up to use interest after tobacco settlement payments end to continue program funding.

"We should have done followed Arkansas but we didn't," Chen acknowledged. "That's because every time you put money in the General fund, there is a temptation to dip into the cookie jar."

So, Chen suggested, a Constitutional amendment to take the tobacco tax money out of politicians' hands was a way to make sure money raised to tobacco cessation and treatment got spent on tobacco cessation and treatment. "That's why it says specifically what percentages go for prevention, for health coverage, for emergency room care and so on," he said.

gexelby@dailystatesman.com