David Brancaccio: The state with the lowest tax on cigarettes? No, not tobacco country -- Virginia or North Carolina. It's Missouri, with a tax of just 17 cents a pack. The national average is a buck and a half. But health advocates are pushing a ballot initiative to increase the levy in Missouri.
St. Louis Public Radio's Maria Altman reports.
Maria Altman: At the Good Times Smoke Shop customers can get almost any pack of cigarettes for less than $5 -- from Marlboros and Camels to an Armenian brand called Tough Guy.
Mary Barber is here to get a carton of Marlboro Reds. Even if Missouri's tax significantly increases, she doubts she'd give up smoking.
Mary Barber: I always said if cigarettes got to $2 a pack, I was quitting. And that was 12 years ago, and I'm still smoking and there a little over $4 a pack, so I don't think it would change me from smoking.
But the American Lung Association says there is a direct link between taxes on cigarettes and the number of people who smoke.
Michelle Bernth: The lower your tax, the higher your smoking rate is going to be, and we're seeing that play out here in Missouri.
Spokeswoman Michelle Bernth says 21 percent of the state's adult population smoke, the 11th highest rate in the country. And she says that costs big bucks
Bernth: The annual healthcare costs directly related to smoking here in Missouri are $2.13 billion with a "b."
Bernth says hiking the cigarette tax would generate some much-needed revenue and also cut those healthcare costs. But Missouri lawmakers are avoiding any tax hike.
Rob Mayer is head of the Republican-controlled Senate.
Rob Mayer: There is philosophically a pretty strong sentiment not to raise any taxes.
Mayer thinks voters have sent a message. He says in the past, Missouri residents voted down ballot initiatives to raise cigarette taxes.
Mayer: They've all been defeated, and so the taxpayers and citizens of Missouri over the years basically have said we don't want any more taxes.
This year, there are a lot of ballot initiatives to increase Missouri's cigarette tax. One proposal is backed by several health groups, including the American Lung Association. The tax would be five times bigger than the current rate.
But a pack of cigarettes in Missouri would still be 55 cents lower than the national average.
In St. Louis, I'm Maria Altman for Marketplace.