Missourians for Health and Education

1. Missourians for Health and Education

2. Why a Tobacco Tax? • Each year thousands of Missourians are diagnosed with tobacco-caused cancers, heart and lung diseases, and many will lose their lives. • Missouri has the lowest cigarette tax (17¢ ) of all states in the nation, and very high smoking and other tobacco product use rates. National average tax is $1.49. • Costs an estimated $581 per household in public expenditures, and claims 9,500 lives per year in Missouri from cancer and other smoking-related diseases. • This ballot measure will mean increased longevity, improved quality of life, and fewer Missourians who will needlessly suffer and die from tobacco-caused diseases. • This is a public health initiative that will impact the lives of Missourians for generations to come, through better health and education.

3. Why a Tobacco Tax? Revenue Win • Provides CDC recommended levels of tobacco control funding • Provides additional revenue for K-12 and Higher Education Health Win • One of the most effective ways to reduce smoking rates and other tobacco product use, and helps prevent our youth from ever starting • Increase is on cigarette and other tobacco products

4. State Tobacco Tax Excise Rates

5. Surrounding States

6. Health Impact in Missouri Smoking Prevalence • Missouri adults 21.1%, Missouri is 11th highest in smoking prevalence now • 19.5% high school students smoke • 8,600 Missouri kids (under 18) become new daily smokers each year. • Annual healthcare costs directly caused by smoking: $2.13 billion • Annual cost of smoking to Medicaid: $532 million

7. $.73 Tax Increase Projected Benefits • Kids in Missouri kept from becoming addicted adult smokers: 40,100 • Current adult smokers in the state who would quit: 33,300 • Smoking-affected births avoided over next five years: 8,200 • Missouri residents saved from premature smoking-caused death: 22,200 • 5-year health savings from fewer smoking-affected pregnancies & births: $17.69 million • 5-year health savings from fewer smoking-caused heart attacks & strokes: $11.80 million • Long-term health savings in the state from adult & youth smoking declines: $1.37 billion

8. Allocation of Funding • 50% Elementary and Secondary Education (emphasis in the classroom) • 30% Universities and Colleges (emphasis on training healthcare providers) • 20% Prevention and Quit Assistance

9. Elementary and Secondary Education • Prevent staff reductions & increased class sizes. • Ballot language includes safeguard to ensure additional revenue to K-12 education (supplement, not supplant) Distribution method • DESE shall distribute • Funds will be distributed based on average daily attendance • Then funds will distributed on a per pupil basis • At least 25% of the moneys shall be used in direct classroom expenditures Purposes, include, but not limited to: • Teacher recruitment & retention, salaries or professional development; • School construction, renovation, or leasing; • Technology enhancements, textbooks, or instructional materials; • School safety; or • Supplying additional funding for required state & federal programs.

10. Higher Education • Department of Higher Education distributes to public colleges and universities • Based on proportion of basic operating appropriations for preceding FY • 25% shall be used for programs related to the education, training, and development of future caregivers • including physicians, dentists, optometrists, pharmacists, nurses, and other healthcare providers

11. Tobacco Prevention and Quit Assistance • Responsible for establishing initiatives to promote tobacco use quit assistance and prevention and public health for tobacco-related disease • including a comprehensive statewide tobacco control program • 15% may be used for public health, including loan forgiveness or scholarships for medical professionals who work in underserved areas

12. Questions?