Area health advocates say two tobacco-tax increases on the Missouri ballot next week fall short of what’s needed to lower smoking rates and save lives.

Tobacco companies have poured millions of dollars into the campaign, larger companies favoring one of the issues and smaller companies opposing it.

“There is a tobacco civil war going on. Big tobacco realizes that they’re probably going to have a tobacco tax, and they want one they can craft,” said Dr. Bridget McCandless of Independence, president and CEO of the Health Care Foundation of Greater Kansas City.

A proponent of one tax increase, however, points out that Missouri has the lowest cigarette tax in the country – 17 cents a pack, unchanged in 23 years – and she says in opposing both ballot issues as insufficient, health advocates are in effect endorsing the status quo.

“We have a long way to go to get back to normal in Missouri in a lot of areas, and this is a step in the right direction,” said Linda Rallo, co-founder of Raise Your Hand for Kids.

Voters go to the polls next Tuesday. Polls are open 6 a.m. to 7 p.m. There are two tobacco issues:

* Constitutional Amendment 3 would phase in a 60-cent-a-pack increase by 2020. That raises about $300 million a year, and the money goes for early childhood health and education.

* Proposition A would increase the tax by 23 cents a pack by 2021. That generates about $100 million a year for roads and bridges, though that’s far short of fully reversing the hundreds of millions of dollars in annual revenue that the Missouri Department of Transportation has sustained in recent years.

Convenience stores in the state worked to get Proposition A on the ballot but had to make what Ron Leone, executive director of the Missouri Petroleum Marketers & Convenience Store Association, called a painful to shift strategy.

“No one’s putting any time or effort into pushing Proposition A because we’re focused on defeating Amendment 3,” Leone said.

That’s because Amendment 3 closes what proponents call a loophole in the 1998 settlement over past marketing practices. That settlement is between the major tobacco companies and 49 states. Those big companies -- like Philip Morris (Marlboro), R.J. Reynolds (Newport, Camel, Pall Mall) -- pay 67 cents a pack under the settlement. Discount cigarette companies -- XCaliber International (Echo, Edgefield and Exeter) and Cheyenne International, which makes Aura, Cheyenne and Decade and calls itself “the biggest small tobacco manufacturer in America” -- don’t currently pay that fee.

Leone says that would add a total of $1.27 to the current 17-cent tax on a pack of discount cigarettes, a 747 percent increase. He said the big tobacco companies are trying to use Amendment 3 to crush their competition.

“It’s important to remember that big tobacco does not care about children. It does not care about early childhood education,” Leone said. “Big tobacco cares about big tobacco.”

While “big tobacco” has spent millions to support Amendment 3, Xcaliber and Cheyenne have put up more than 80 percent of the money the convenience stores have spent fighting it.

Leone said convenience stores sell “big tobacco” and “little tobacco” products, but McCandless said the discount brands are crucial. “It’s one of their best revenue drivers,” she said.

Health advocates point out that the American Cancer Society, American Heart Association and American Lung Association oppose both tax issues. They also say the increases aren’t enough to appreciably lower the number of smokers, which they say should be the chief objective of a tobacco tax.

“So you hate to squander an opportunity like that,” McCandless said.

“These proposed changes will have a minimal effect on smoking behavior,” Dr. Michael O’Dell, chair of the Department of Community and Family Medicine at the University of Missouri-Kansas City School of Medicine, wrote earlier this year. “The absolute minimum ‘dose’ of tobacco tax needed to affect youth smoking is 10 percent of the purchase price, or 52 cents a pack, all at one time. In order to make a real impact on the behavior of our price-sensitive teens and young adults, a more realistic goal is 75 cents.”

The Health Care Foundation says the national average cigarette tax is $1.60 and that a $1 increase in Missouri would keep 39,600 people from taking up smoking, save 24,400 from premature death related to smoking, and save $46 million in health-care costs in five years.

Rallo, of Raise Your Hand for Kids, said her group settled on the 60-cent increase proposed in Amendment 3 because that was the highest level that polling supported.

“It was very intentional. … It’s not like we just picked a number out of a hat,” she said, adding that her group offered to work with health advocates.

Rallow said she’s frustrated at what she calls the lies about Amendment 3. It won’t ban tobacco research, she said, but none of the Amendment 3 money could go for that. It’s the same for stem-cell research, she said. The money is locked into a trust fund, she said.

“You know, it’s a battle. It’s a battle between two tobacco (interests),” she said. “We’re just trying to work for kids.”


Campaign funding

According to papers filed with the Missouri Ethics Commission, as of Monday the major players had raised and spent more than $18 million. Those include:

* Raise Your Hand for Kids, which supports the 60-cent increase under Amendment 3, reports having raised $3.24 million, including $2.65 million from RAI Services Company of Winston-Salem, N.C., a subsidiary of Reynolds American. RAI Services also has made $2.78 million in in-kind contributions.

* Vote Yes on 3 for Kids, based in Jefferson City, reports having raised $2.46 million as of Monday, including $2.35 million from RAI Services and another $2.45 million in in-kind contributions from RAI Services.

* The Missouri Petroleum Marketers and Convenience Store Association Political Action Committee reports having raised $5.79 million as of Monday, including $2.36 million from Cheyenne International (plus $2.36 million in kind) and $2.39 million from Xcaliber International (plus $2.35 million in kind).

* We Deserve Better Inc., a group whose stated purpose is to oppose tobacco taxes, reports having raised $641,963. The Missouri Coalition for Lifesaving Cures, inc., which supports stem-cell research, has given $631,863 of that amount, plus the same amount listed as in-kind contributions.


Note: This story has been corrected to clarify two references to criticisms of Amendment 3.