2015-08-18 P-D: “Higher Tobacco Taxes?”

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Higher Tobacco Taxes? was the lead story on the front page of today’s St. Louis Post-Dispatch, describing two proposals to raise the cigarette tax from 17 cents a pack to 40 cents. What is most intriguing is that both are spearheaded by the self-same group, the Missouri Petroleum Marketers and Convenience Store Association, led by Executive Director Ron Leone, that has successfully opposed previous efforts to raise Missouri’s lowest-in-the-nation cigarette tax.

[For a previous blog featuring Ron Leone please click here: 2012-11-07 P-D: “Missouri keeps tobacco tax as the lowest in the nation”]

It transpires that this is being pursued not for altruistic reasons but to head off a potentially larger tax increase if a competing initiative to raise the tax by 50 cents to 67 cents a pack is successful.  How marvelously devious.

New campaign to raise Missouri’s tobacco tax could fund transportation projects 

21 hours ago  •  By Leah Thorsen

69 on-line comments to date


Missouri’s 17-cent per pack tax on cigarettes is the lowest in the nation. Here’s a look at what Missouri’s neighboring states impose:

Illinois: $1.98
Iowa: $1.36
Kansas: $1.29
Arkansas: $1.15
Oklahoma: $1.03
Nebraska: 64 cents
Tennessee: 62 cents
Kentucky: 60 cents

Source: Campaign for Tobacco-Free Kids

The latest appeal for an increase in Missouri’s tobacco tax came Monday from an organization that has successfully fought to keep the state’s tax the lowest in the nation.
          The Missouri Petroleum Marketers and Convenience Store Association filed two nearly identical versions of an initiative petition seeking a statewide vote to raise the tax on cigarettes to 40 cents a pack.
          That’s a 135 percent increase, but it’s less than two other proposals being floated and more likely to win voter approval, the trade group says.
          One of the group’s proposals could mean $800 million over a decade to be used for transportation funding, it says. Any measure would require a signature-gathering campaign before going before voters.
          Missouri’s current state cigarette tax is 17 cents a pack, the lowest of any state in the nation.
          The proposed increase would be phased in, with an additional 13-cent tax per pack going into effect on Jan. 1, 2017; an additional 5 cents on Jan. 1, 2019; and the remaining 5 cents on Jan. 1, 2021.
          The group — which fought all three tobacco-tax increases ultimately rejected by voters since 2002 — also is proposing a 50 percent tax increase on other tobacco products.
          Under one version, the proceeds would fund transportation. Under the other, the money would go to the state’s general revenue fund.

Ron Leone

Ron Leone

          Ron Leone, executive director of the Missouri Petroleum Marketers and Convenience Store Association, said his group will see which is more popular with voters, but he expects Missouri voters to support the version allocating the extra money to fund transportation projects. He also said it would allow Missouri stores to keep their tax advantage over border states.
          A 40-cent tax on cigarettes would keep Missouri’s tobacco tax among the lowest nationwide, topping only Georgia and Virginia, which impose tobacco taxes of 37 cents and 30 cents respectively, according to the Campaign for Tobacco-Free Kids.
          He said the hike would be equivalent to a 3-cent hike in the gasoline tax. A measure to increase the state’s fuel tax by 2 cents died this year in the Legislature, and that has caused the state to dial back on transportation spending.
          No Missouri Department of Transportation expansion projects, such as new lanes, interchanges or bridges, are planned over the next five years. That represents a first in the department’s history, the result of a bleak funding outlook.
          The belt-tightening comes as MoDOT braces for lean years after the death of the fuel tax hike and rejection by voters of a sales tax increase that would have provided about $5.4 billion over 10 years for roads and bridges as well as ports, railways and public transit.
         “Would it solve our transportation problems? No,” Leone said of his group’s proposal. “Would it help our problems? Absolutely.”
          If successful in collecting enough signatures — a minimum of 157,788 from six of Missouri’s eight congressional districts — a measure would be up for a vote in the November 2016 election. The two initiatives submitted Monday to the secretary of state’s office brings the total to 80.
          And Leone’s group isn’t the only one with an idea for where money from a tax-hike on tobacco could go.
          Missouri Attorney General Chris Koster, a front-runner for the 2016 Democratic gubernatorial nomination, in Marchcalled for the state to pass a cigarette tax hike to around 90 cents a pack with the money earmarked to fund college scholarships for state students. No such petition has been filed to get that measure on the ballot.
          The group Raise Your Hand for Kids has filed its petition and is also pursuing a November 2016 ballot initiative to increase Missouri’s tobacco tax and use the money for early childhood education and health screenings for children ages birth to 5.
          The group wants to increase the tax by 50 cents — to 67 cents a pack — to bring in an additional $250 million a year for screening programs, home visits and child care from birth through age 5.
Under the plan, St. Louis County, with the highest population of young children in the state, would gain about $37.5 million in funding. St. Louis would gain nearly $14 million. St. Charles and Jefferson counties would gain $15.7 million and $9.5 million respectively.
          But voters have turned down other tax hikes, most recently in 2012 when they were asked to raise tobacco taxes by 73 cents a pack. Nearly 51 percent of voters rejected the plan to raise $283 million for smoking cessation programs, K-12 education and higher education.

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2015-04-23 P-D Comics: Dilbert’s attitude to smoking

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In today’s comics section of the St. Louis Post-Dispatch Dilbert had something to say about smoking during a technical interview:

Dilbert dt150423

Well, I didn’t know about this 2010 Israeli study either and I found it surprising. In part, that was because my former next door neighbor in Harlow, England, who had a Ph.D. in Chemistry, was a bright guy working for 3M and also an addicted smoker. (He finally quit, thanks to pressure from family members, including his asthmatic son.)

Dr. Evarts Graham, Washington University School of Medicine, St. Louis, was a long-time cigarette smoker who, together with Ernst Wynder, was the first to report a definitive link between smoking and lung cancer. Dr. Graham later died of lung cancer in 1957 at age 73.

So, back to Dilbert’s reference to a 2010 Israeli study that smokers have a lower IQ than nonsmokers. It turns out that there IS such a study, and you can find it reported here:

Smoking linked to lower IQ’s


But it’s not that smoking LOWERS your IQ. It’s that those with LOWER IQ’s are more likely to smoke. As reported in the article, Dr. Mark Weiser from the Sheba Medical Center at Tel Hashomer Hospital in Israel said:

“It’s very clear that people with low IQs are the ones who choose to smoke. It’s not just a matter of socioeconomic status – if they are poor or have less education – and because of that do less well on IQ tests. And that’s really the story,” he says.

Protected: The Little (smoke-free) Engine that could(n’t quite prevail in St. Charles County)

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2015-04-13 P-D Bill McClellan: “Lung cancer doesn’t get the attention it deserves”

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Today’s column instantly brought back memories of my late sister, Lilian, a nonsmoker who nonetheless died of lung cancer shortly before her 58th birthday in England in 1988. She was lying in bed unconscious by the time I arrived, after flying via TWA from Lambert-St. Louis International Airport to Gatwick Airport in southern England. I had always admired her for being pretty but on this occasion her face was distorted, as though she was trying to escape from her skin, and she was taking raspy breaths. She never did regain consciousness before she died hours later.

In 2009 I memorialized her death in a blog, illustrated with photos of happier times, and posted on November 11th, the date that she died, titled:

In Memoriam: Lilian (Leah) Williams, nee Pion

Below I’ve pasted Bill McClellan’s on-line column, which in the print version is titled “Lung cancer doesn’t get the attention it deserves,” which I think is a better title so I’ve used it for this blog.

One thing that struck me in McClellan’s column below is this paragraph:

“There is no behavioral link to breast cancer, no one blaming the patients, no one asking if they were smokers.”

Dr. A. Judson Wells

Dr. A. Judson Wells

In 1987 I read a ground-breaking paper by A. Judson Wells, Ph.D., which estimated non-smoking deaths due to secondhand smoke exposure, and included breast cancer deaths among them.
This was at a time when any such association between secondhand smoke and breast cancer was generally dismissed by the medical community. I believe that association has now been recognized.

P.S. After posting this I received the following e-mail from a former St. Louis resident, good friend, and mogasp supporter. He was kind enough to allow me to post it without attribution:

“Thanks for forwarding Bill’s column with your commentary.
We had a very good friend who never smoked and her husband was a very heavy smoker. She eventually died of lung cancer and it devastated my wife who had become very fond of this woman. We were unable to maintain contact with her husband (the couple had moved to Quebec, Canada).
Your sister in Brighton brought back memories.
In 1936 my older sister was put into a boarding school in Brighton for a year since public schools in Germany were closed to Jews. I followed to the UK a year later (9/37) and we both ended up in Bournemouth (of course at two different boarding schools).
On Thursday, 4/16, we celebrate 76 years since we landed in New York.
Had I told you before that the community to which we’ve retired is now smoke free within 25 feet of any window or doorway of any community building?
Life is good out here in the great Northwest.”

What’s truly an amazing coincidence is that my family moved from East London to Bournemouth shortly before WWII on the advice of a family doctor. He said my sister, who had severe bronchitis, would not survive if we remained in London’s dirty air, polluted from numerous homes heated by inefficient coal fires. He recommended Bournemouth, a seaside town in the middle of the south coast, for the “healthy ozone” from its many pine trees.

Another reason we might not have survived was this. When my family visited London shortly after the end of the war, half of Sigdon Rd. in East London where we had lived had been destroyed by a V2 rocket!

Those with lung cancer find themselves fighting on two fronts
13 hours ago • By Bill McClellan

Bill McClellan banner FS 500 96 (M 300 58)

Larry Less woke up one morning five years ago with the taste of blood in his mouth. He was 61 and lived alone. He thought about driving himself to the emergency room and then decided to call an ambulance.
Two days later, he woke up in a hospital. A doctor told him he had had a heart attack. Also, he had terminal lung cancer. He was my oldest friend. I wrote about visiting him before his death. He was a skeletal figure and he still smoked. Why quit?
Shortly after Larry’s death, Beth Radinsky began having a pain in her hip. She was 65. People that age get random pains. She understood that. She was a physical therapist. Later, she had chest pains and went through a battery of tests. Lung cancer. She had never smoked.
By the time her cancer was diagnosed, it had spread. The pain in her hip? Cancer had eaten up the hip bone. She died in September of 2013.
Larry and Beth represent two sizable minorities among people diagnosed with lung cancer. Twenty one percent are smokers. Eighteen percent never smoked. The rest are former smokers, many of whom have been off cigarettes for years, even decades.
Still, the link between smoking and lung cancer has stuck lung cancer patients with a stigma that other cancer patients don’t have to deal with.
Cheryl Lamprecht was diagnosed with lung cancer in 2005. She had never smoked. She went to the Siteman Cancer Center to get information about support groups. There were none.
Later, she met another lung cancer patient who had also unsuccessfully looked for a support group. Myrtle Chidester was a former smoker. She had been off cigarettes for 20 years when she was diagnosed with lung cancer in 2005.
The two women became their own support group. Then they founded an actual support group in 2009. They called it Lung Cancer Alliance. It is now called Lung Cancer Connection. They wanted to do more than support other patients. They wanted to advocate for more research money. Lung cancer is one of the least-funded cancers despite the fact that it claims more lives than breast, prostate, colon, liver and kidney cancers combined.
Also, they wanted more emphasis on early detection. One reason it is so deadly is the low rate of early detection.
Cheryl was fortunate in that regard. She had a chest X-ray taken because of a persistent cough. The first diagnosis was pneumonia. Seven months later came the diagnosis of lung cancer.
She had half of her left lung removed and underwent chemotherapy. She was cancer-free for five years. Then she was diagnosed with breast cancer.
No one wants to be a connoisseur of cancers, but Cheryl could not help but notice the difference between the two. There is no behavioral link to breast cancer, no one blaming the patients, no one asking if they were smokers. Perhaps the more profound difference was this — at a run for breast cancer in which survivors wore pink, Cheryl, wearing pink herself, saw a sea of women wearing pink.
At a walk organized by the Lung Cancer Connection in 2009, there were less than a dozen survivors.
In fact, the five-year survival rate for lung cancer is 15.9 percent. For breast cancer, it is 98.6 percent. For that matter, more women die of lung cancer than of breast cancer. That is not meant to minimize breast cancer. My sister died of breast cancer when she was 34.
Myrtle died in 2012.
I met with Cheryl and several members of the Lung Cancer Connection last week. Among the members was Bob Radinksy, Beth’s husband. He talked about the need for early detection. The group provides money for screenings. X-rays, CT scans. People don’t understand everybody is at risk, Bob said. Not all insurance companies provide screenings for people with no risk factors.
Bob first called me in the summer of 2013. I had written a column comparing life to walking across a frozen lake.
“We just fell through the ice,” he said.
Roy Williams was also in the group. He is 66 and he quit smoking almost 30 years ago. He had a chest X-ray two years ago, and doctors discovered early stage lung cancer. He will be among the survivors on the stage this Saturday when Lung Cancer Connection holds its annual walk at the Chesterfield Amphitheater.
Originally, the group held the walk in November. That’s Lung Cancer Awareness month. A November walk didn’t work well because of the weather, but that’s the way it goes for lung cancer patients and their advocates.

Bill McClellan worked as a reporter in Phoenix before coming to the Post-Dispatch in 1980. He was night-police reporter before becoming a columnist in 1983. He also appears on Channel 9’s Donnybrook.

2015-02-15 HBO: Last Week Tonight with John Oliver: Tobacco

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John Oliver Tobacco sh

John Oliver: “Tobacco. It used to be a cornerstone of American life. It’s how we knew sex was over before the female orgasm was invented.”

Please click still image above or the following live link to view:

Last Week Tonight with John Oliver: Tobacco (HBO)

Thus is this 18 minute romp through the ins and outs of the tobacco industry reviewed in hilarious fashion by British comedian and former Daily Show faux-reporter, John Oliver, on his new HBO show. If you can’t spare a full 18 minutes, ration it out but don’t miss it.

2014-12-21 P-D: Doonesbury’s Mr. Butts year-end cartoon

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In case any of you missed it and as a year-end treat, please find below the December 21st, 2014, Sunday Doonesbury cartoon from the St. Louis Post-Dispatch, featuring Mr. Butts and his buddy, Mr. Brewski.

Who can addict and kill more people? It’s no contest!

(Please click to enlarge the strip below.)

Doonesbury Mr Butts & Mr Brewski db141221

Study Ranks Missouri as Worst State for Combating Lung Cancer

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In the following TV interview transcript, Dr. Jim Blaine is quoted as saying:

“Lung cancer, by the time we detect it, it’s usually too late.”

That was certainly the case for my older sister and only sibling, Lilian. By the time she saw a specialist complaining of a persistent cough she thought was bronchitis she got the diagnosis that it was incurable, inoperable lung cancer. She died six months later, on November 11th, 1988.

I believe the survival rate for lung cancer is only about 10% because by the time it’s detected it has usually spread to the lymph nodes and elsewhere in the body.

KOLR 10 TV, Springfield, MO, at http://www.ozarksfirst.com/
The following was a report on the above story, posted on-line 11/16/2014 06:21 PM:

This link to an interactive map on Wallethub shows the best and the worst states for combatting lung cancer, based on tobacco tax level, with Missouri being the worst:


SPRINGFIELD, Mo. – A new study from WalletHub ranks Missouri as the worst state in the country for combating the high cost of lung cancer.

 Jim Blaine, MD

Jim Blaine, MD

Missouri finished 51st overall, behind the 49 other states and Washington D.C. Wallethub, a social networking site dedicated to personal finance topics, pored over data from the U.S. Census Bureau, CDC and American Cancer Society to put together the rankings.
         KOLR10 spoke Sunday with Jim Blaine, a Springfield doctor who has worked on past campaigns to raise Missouri’s cigarette tax. Blaine said there are a lot of users in Missouri and few incentives for them to quit.
         “My reaction is I’m not surprised at all and yes we absolutely deserve that ranking,” Blaine said. “Missouri has as you know the lowest tobacco tax in the nation at 17 cents and even at that, we spend virtually nothing on prevention.”
         Wallethub ranks Missouri at 34th in the number of adult users, 44th when it comes to the death rate from lung cancer, 48th in the price of a cigarette pack and 45th in the estimate of new lung cancer cases per capita.
         Lung cancer has a low survival rate of 16.6 percent and Blaine said it is hard to reverse that trend.
         “Lung cancer, by the time we detect it, it’s usually too late,” Blaine said.
         Blaine said the cure for lung cancer is simple, get people to stop smoking. However, Blaine said it is possible people are not getting the message. Wallethub ranks Missouri at 39th in the percentage of people trying to quit.
         Missouri generated $184 million in tobacco revenue last year and only spent about $76,000 on tobacco prevention, much lower than the CDC’s $73 million recommendation.
         Blaine said if the state got the word out and raised cigarette taxes, the trends could be reversed.
         “You know actually just raising the price. Every 10 percent increase in the cost of cigarettes you get a 7 percent decrease in the user rate,” Blaine said.
         Missouri voters have voted down efforts to increase the state’s tobacco tax three times — the last was on the 2012 ballot. The 2012 proposal would have raised anywhere from $283-423 million a year for the state and 20 percent of the revenue would have gone to tobacco prevention efforts.