tobacco

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This story was updated at 4:13 p.m.

Missouri has settled a dispute over the terms of a multibillion settlement with the big tobacco companies that has cost it tens of millions of dollars over the last dozen or so years.

Attorney General Chris Koster announced the settlement Monday, saying it will allow the state to recoup $50 million it lost in arbitration and preserve millions of dollars in future payments.

Susie Fagan / Heartland Health Monitor

Several nonprofit organizations that advocate for children, minorities and low-income Kansans are concerned about what they see as a trend toward less open government in Kansas.

Now they’ve joined forces to launch what they’re calling the Open Kansas initiative and to ask legislators to sign a “transparency pledge” to taxpayers. The pledge commits those who sign it to support:

Alex Smith / Heartland Health Monitor

Around a quarter of adults in Wyandotte County, Kansas, smoke. That’s about twice the rate in Johnson County and well above the state average. Wyandotte County’s government recently created a coalition of partners to find ways to address the problem. For the latest in our series KC Checkup, we talked with Rebecca Garza, coordinator of Tobacco Free Wyandotte, who began by explaining the significance of  Kansas City, Kansas’ recent decision to raise the legal age for the sale of cigarettes and other tobacco products to 21.

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Independence, Missouri, on Monday became the third major municipality in the Kansas City area to raise the legal age of sale for tobacco products to 21 from 18.

Following similar votes in the last two months by Kansas City, Missouri, and the Unified Government of Wyandotte County/Kansas City, Kansas, the Independence City Council approved the measure by a 6-1 vote at a council meeting last night.

Andy Marso / Heartland Health Monitor

Editor’s note: This is one in a series of articles previewing health-related issues that the Kansas Legislature will face in its upcoming 2016 session.

The 2015 session of the Kansas Legislature began with a budget crisis and Gov. Sam Brownback proposing a large hike in the state tobacco tax to help solve it.

The 2016 session is set to begin in January with the budget again in need of patching. But the kind of tobacco tax increase anti-smoking advocates believe would spur Kansans to kick the habit is less likely.

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The governing bodies of both Kansas City, Missouri, and Kansas City, Kansas, voted Thursday to raise the legal age for buying tobacco and electronic nicotine-vapor products from 18 to 21 in their communities.

Advocates have said studies indicate that as many as 95 percent of adult smokers say they started smoking prior to age 21. 

They also have pointed to studies showing that 18-year-old smokers often become the “connection” for younger members of their high school social network, some as young as 14.

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A Kansas City Council committee on Wednesday approved three anti-smoking measures that critics said wrongly include electronic cigarettes and premium cigars.

Taken together, the three ordinances raise the legal age for purchasing tobacco products and e-cigarettes from 18 to 21 and add e-cigarettes, also known as vapes, to the city’s ban on indoor smoking, including in so-called vape shops that sell them.

Mike Sherry / Heartland Health Monitor

Supporters of banning the sale of cigarettes to teens and young adults in the Kansas City area may be close to landing their first major coup.

On Monday night, a legislative committee of the Unified Government of Wyandotte County/Kansas City, Kansas, one of the region’s largest municipalities, endorsed revising its legal code to ban the sale of cigarettes to anyone under the age of 21. The current age under state law is 18.

 The Health Care Foundation of Greater Kansas City is out with a new report that looks back at the successes and setbacks of the last decade when it comes to the region's health. We discuss the report's findings on healthy eating and active living, tobacco prevention, oral health, behavioral health and physical health.

Guests:

Mike Sherry / Heartland Health Monitor

Business and health leaders on Thursday announced an ambitious initiative to convince elected officials in the dozens of municipalities throughout the Kansas City area to raise the legal age for buying cigarettes from 18 to 21.

Spearheaded by the Greater Kansas City Chamber of Commerce and Blue Cross and Blue Shield of Kansas City, “Tobacco 21 | KC” aims to build on a movement that now counts nearly 100 communities around the country and the state of Hawaii that have made 21 the legal age for purchasing tobacco products.

Dave Ranney / Heartland Health Monitor

Studies have shown that nearly half of the cigarettes consumed in the United States are smoked by people thought to have a mental illness.

At the same time, people who have a mental illness die an average of 25 years earlier than those who don’t have a mental illness.

“There’s a really big disparity in who’s smoking and in who’s dying,” said Kim Richter, who runs the tobacco cessation program at the University of Kansas Medical Center in Kansas City, Kan.

“And we as a society haven’t really done anything about this,” she said. “We really need to turn this around.”

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The cigarette tax increase Kansas legislators approved in June to help close a budget gap has not dissuaded people from buying smokes in Kansas — at least not yet.

The state cigarette tax climbed from 79 cents per pack to $1.29 per pack on July 1, an increase of 63 percent. Tax revenue from cigarette sales for July 2015 was up 64 percent over July 2014, which means people purchased about the same amount of cigarettes in Kansas as they did before the tax hike, if the underlying cost of a pack of cigarettes stayed relatively close to last year’s price. (Data on the average price of a pack of cigarettes in Kansas last month is not yet available.)

That’s significant, because the prospect of higher taxes spurring Kansans to quit was used as an argument both for and against the tax hike.

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Kansas and Missouri are in the bottom half of the class in a new report from the American Cancer Society’s Cancer Action Network.

The report, “How Do You Measure Up,” judges states on a variety of policies related to cancer control and prevention. It uses a traffic signal color scheme to indicate state legislative progress: green for a positive trend, red for serious shortcomings and yellow for somewhere between.

Mike Sherry / Heartland Health Monitor

Special interests have long eyed Missouri’s lowest-in-the-nation cigarette tax as a potential pot of gold, if only voters would agree to hike the 17-cent-per-pack levy and direct the windfall to health and education programs.

Yet tax-hike advocates have failed narrowly at the polls three times going back to 2002, and the landscape is not much different as another campaign girds for battle next year.

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It’s over.

Republican legislators from the House and Senate mustered just enough votes to pass a $400 million tax increase Friday and end the historic 2015 session.

The session traditionally lasts 90 days. Friday was the 113th, as both chambers struggled to get Republican supermajorities to approve a substantial tax hike.

The final plan raises the state sales tax from 6.15 percent to 6.5 percent. Senators ultimately gave up on a quest to tax groceries at a lower rate.

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While health advocates cling to the possibility of Kansas lawmakers using a large tobacco tax increase to help solve the state budget crisis, Statehouse momentum is heading toward a much smaller increase — or none at all.

Groups like the American Cancer Society, American Heart Association and the University of Kansas Cancer Center praised Gov. Sam Brownback’s January proposal to raise cigarette taxes by $1.50 per pack and smokeless tobacco taxes by a similarly large amount.

A couple of items relevant to public health and the health insurance industry are in the mix as lawmakers seek a tax plan that will allow them to end the 2015 session.

Kansas legislators need to locate between $400 million and $500 million in new revenue to fund the budget for the fiscal year that begins July 1. As the House and Senate move toward the 90th day of the legislative session, most debate has focused on how much of that new revenue should come from rolling back income tax cuts passed in 2012  and how much should come from new sales taxes.

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The chairman of the Senate committee working on a plan to address the projected budget deficit in Kansas is confident that a tobacco tax increase will be a part of the final package.

However, public health advocates are concerned that the increase won’t end up being large enough to significantly lower smoking rates and reduce expenditures on smoking-related illnesses. They continue to favor a proposal that Gov. Sam Brownback announced at the beginning of the session to increase the cigarette tax by $1.50 per pack.

Andy Marso / Heartland Health Monitor

Advocates of raising Kansas’ tobacco tax made one last push Monday during a rally at the Statehouse, with a prominent physician saying cancer will overwhelm the state’s health care system if the tax isn’t raised.

Legislators will look this week at options for raising $400 million to $500 million to close a budget gap and end the 2015 session.

More pessimistic state revenue estimates released this week could breathe new life into tobacco and alcohol tax increases that lawmakers thus far had ignored.

The state’s Consensus Revenue Estimating Group said Monday that Kansas should expect to collect about $5.71 billion in taxes in the fiscal year that begins July 1. That’s almost $100 million less than the group of economic experts estimated in November, making a difficult budget puzzle even more vexing for legislators.

The American Cancer Society’s Cancer Action Network quickly seized on the new projections as evidence legislators should increase the tobacco tax.

“Making tobacco significantly more expensive is a powerful economic tool that will save lives and cut health care costs while also addressing Kansas’ budget shortfall,” said Reagan Cussimanio, the group’s government relations director in Kansas.

Andy Marso / Heartland Health Monitor

Kansas legislators are trying to determine what they should do, if anything, to regulate hookah.

But first, several of them have to determine exactly what hookah is.

“Having lived a very sheltered life in southeast Kansas, I had to Google this to even find out what it was,” Rep. Jim Kelly, a Republican from Independence, said during an informational hearing on the subject last week.

Hookahs are water pipes used to smoke flavored tobacco.

To Hani Chahine, they’re also a focal point for social gatherings and commerce.

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A university researcher says his data suggests a proposed tax increase on cigarettes would provide a stable revenue stream for the state while also generating big saving on health care costs.

Frank Chaloupka, an economics professor from the University of Illinois at Chicago, said the $1.50-per-pack increase would cause some Kansans to quit smoking, but not enough to offset the revenue gained from those who continue. The savings in health care costs from those who do quit could amount to $1 billion over five years.

Public health advocates are cheering proposed changes to the state tax code that would encourage healthy behaviors. But Gov. Sam Brownback and the legislators who pitched them face challenges in getting them passed.

As part of a larger effort to fill a gaping budget hole, Brownback called for increasing taxes on tobacco and alcohol. The tobacco tax in particular has gathered support from the state’s health community.

 

The state board that oversees Kansas’ public colleges and universities on Wednesday endorsed an effort by the University of Kansas Cancer Center to earn the highest level of recognition from the National Cancer Institute (NCI).

The Kansas Board of Regents backed the initiative by approving a resolution that said, in part, that the cancer center “would substantially improve cancer research and treatment opportunities for Kansans” by earning the enhanced designation.

Andy Marso / Heartland Health Monitor

 

As Kansas legislators voted this week on a budget bill to keep the state solvent through the current month, Rep. Larry Hibbard laid down a gauntlet.

Hibbard, a rancher, Republican and self-described “common sense conservative” from rural southeast Kansas, said the price of his “yes” vote to keep state government running was an open debate about the income tax cuts spearheaded by fellow Republican Gov. Sam Brownback in 2012 — tax cuts he blames for the budget shortfall.

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States continue to spend a miniscule portion of the billions of dollars they collect annually in tobacco revenues on smoking prevention and cessation programs, according to a new report by six leading health organizations.  

Missouri spent $76,314 on tobacco prevention in the latest fiscal year, the report says. The Centers for Disease Control and Prevention recommended it should have spent nearly $73 million.

Only one state, New Jersey, spent a smaller percentage of its tobacco funds on anti-smoking programs. New Jersey allocated no funds for tobacco prevention.  

Mike Sherry / Hale Center for Journalism at KCPT

The Kansas City of the future would be a place where people have affordable medical care, policymakers work with the community on health issues and residents suffer less from chronic diseases and violence.

That, at any rate, is the consensus that emerged Saturday at a forum in Kansas City, Mo.

And it was just the start of what participants said a vigorous metropolitan area should look like in the next decade.

Alex Smith / KCUR

Carlo Cavallaro pours a brown liquid into a device that looks a little like a Star Trek phaser. When it hits battery-heated coils, the liquid sizzles and turns into vapor. He takes a big draw and exhales a sugary-smelling cloud.

Cavallaro makes his own custom nicotine-infused e-cigarette juice.

“This one that I have here is a fudge brownie,” he says.

E-cigarettes have only been around the United States for about seven years, and during that time they have been left largely unregulated by the federal government or most state governments, including Missouri.

As a kid growing up in Grandview, Mo., Michael Thompson began smoking cigarettes at the age of 13. Thirty-four years later, in 1997, he came down with lung cancer.

In 2000, he filed a personal injury suit in Jackson County Circuit Court against the makers of the cigarettes he smoked. A jury awarded him $1 million. A state appeals court later upheld the verdict.

In 2009, Thompson died of throat cancer. His widow and children then filed a wrongful death action in state court against  two of the manufacturers, R.J. Reynolds Tobacco Co. and Philip Morris USA.

Rankings from the United Health Foundation show Kansas is on a long, steady decline — from 8th healthiest state in 1991 to 27th in 2013.

To address the problem, health officials from all over the state are spending two days in Wichita at the Kansas Health Foundation Symposium. The event is a call to action to make Kansans healthier.

"That is the purpose of this conference—to spark the discussion to help us reverse this horrible trend in Kansas," said Kansas Health Foundation President and CEO Steve Coen, summarizing the need for the symposium.

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