Missouri ranks next to last among all 50 states in terms of how much of the 1998 tobacco settlement it has used for smoking prevention and cessation efforts, according to a new report.
Only Connecticut - which spends nothing on the programs - spends less.
Missouri is budgeted to spend $171,582 this fiscal year on those sorts of programs. It spent $48,000 on them in the previous fiscal year.
State attorneys general from 46 states, five U.S. territories and the District of Columbia reached the Master Settlement Agreement with the four largest cigarette manufacturers in America. The agreement concerned the advertising, marketing and promotion of cigarettes, according to publichealthlawcenter.org.
The Campaign for Tobacco-Free Kids said in its annual report "Broken Promises to Our Children" that "Despite receiving huge sums from the settlement and collecting billions more in tobacco taxes, the states continue to short-change tobacco prevention and cessation programs."
The programs, it said, are proven to save lives and reduce health care costs.
The 25-plus-year agreement required the tobacco industry to pay the settling states billions of dollars annually (and to date have paid more than $100 billion). Missouri received $262.1 million through the settlement for 2019. The majority of settlement revenue is used to help fund the state's Medicaid program (MO HealthNet). The state also uses some of the money for its Department of Elementary and Secondary Education and Department of Social Services (for childhood development and child care).
The Centers for Disease Control and Prevention (CDC) recommends the state should have spent about $72.9 million (or about 28 percent) on the prevention and cessation programs. The state annually uses only about .1 percent on the programs.
Missouri isn't alone in underfunding the programs, according to the report. Overall, states will only use about 2.7 percent of the revenue for the programs this fiscal year.
Only three states - California, Alaska and Maine - fund even 70 percent of their CDC recommendations.
"States with well-funded, sustained tobacco prevention programs continue to report significant progress," according to the report. "Another strong year from California helped bring its high school smoking rate down to a record-low 2 percent. Florida, with one of the longest-running programs, reduced its high school smoking rate to 3.6 percent in 2018."
Data show about 28,800 high school students in Missouri smoke. That's about 9.2 percent of high school students in the state. Additionally, 10.9 percent of high school students use e-cigarettes (or vapes).
Among the state's adults, about 921,400 (19.4 percent) smoke.
The report states smoking causes about 11,000 deaths annually in the state. Smoking is responsible for $3.03 billion in spending on health care annually in Missouri, which has the lowest tobacco tax in the nation.
"Along with separate policy actions, including higher tobacco taxes and comprehensive smoke-free laws, state tobacco prevention programs have helped drive down smoking rates to record lows - 13.7 percent among adults and 5.8 percent among high school students (nationally)," the report states. "But tobacco use still kills more than 480,000 Americans and costs the nation about $170 billion in health care expenses each year."