Send the money to outer space


Missouri’s lowest-in-the-nation tobacco tax has created some very interesting politics, with three separate groups vying to increase the tax on the November 2016 ballot. A common strain in all three proposals is that they propose to use the revenue generated from a tobacco tax for non-health issues (namely, transportation, early education, and higher education). This dynamic is understandable.

Missouri’s woefully low tax is the easiest target for generating new revenue for new or underfunded programs. In the midst of this “three-way” primary, the message that seems to be lost is the public health value of increasing cigarette taxes. Increased tobacco pricing is an evidence-based tool to reduce youth and adult smoking.

Here are some key facts:

  • 95 percent of current adult smokers began smoking before the age of 21. Preventing tobacco use between the ages of 12 and 21 is a critical strategy to reduce smoking across the ages.
  • Youth are particularly price-sensitive. A 10-percent increase in tobacco pricing leads to a 7-percent reduction in youth smoking.
  • Not all tobacco tax increases are created equal. Taxes that are too low or phased-in have significantly less (sometimes even no) public health value. Tobacco taxes work when the price increase is significant enough to shock consumers into behavior change. A dime here or there is not sufficient. Plus, tobacco companies are adept at finding ways to absorb small tax increases through adjusted pricing.
  • A $1 increase in Missouri’s tobacco tax promises significant health benefits, including:
    • 14.7-percent decrease in youth smoking
    • 40,000 youth prevented from becoming adult smokers
    • 45,000 currently adult smokers who quit
    • 24,000 premature deaths prevented
    • $313 million in new annual revenue

This last bullet point on new annual revenue is what most people see: a big pile of money to be spent in a state that needs additional resources. Quite understandably, lots of groups are jockeying to be the beneficiary of this new revenue, but amidst that backdrop, we can NOT lose sight of the many other benefits of a tobacco tax increase.

When HCF decided to support a 2012 effort to increase the tobacco tax in Missouri, there was significant discussion about where the added revenue should go. Norm Siegel, our board chair at the time, suggested that the question was of little relevance. While seeing additional resources dedicated to tobacco cessation or direct medical care would be great, tobacco taxes improve population health regardless. The money could be burnt or sent to outer space and our public health goal would still be achieved.

Regardless of where added revenue goes, cigarette tax increases are a vital strategy to decrease youth smoking and prevent smoking-related deaths.

Policy, Tobacco

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HCF's Local Health Buzz Blog aims to discuss health and health policy issues that impact the uninsured and underserved in our service area. To submit a blog, please contact HCF Communications Officers, Jennifer Sykes, at


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