Tobacco use in Missouri 2018

Cigarette use: Missouri*

• In 2016, 22.1 percent of adults smoked. Nationally, the rate was 17.1 percent.¹
• In 2017, 9.2 percent of high school students smoked on at least one day in the past 30 days. Nationally, the rate was 8.8 percent.²

Other tobacco product use: Missouri

• In 2015, 3.1 percent of adults used e-cigarettes, 2.0 percent used smokeless tobacco and 2.0 percent smoked cigars.³
• In 2017, 10.9 percent of high school students used e-cigarettes, 6.1 percent used smokeless tobacco and 9.2 percent smoked cigars on at least one day in the past 30 days. Nationally, the rates were 13.2 percent, 5.5 percent and 8.0 percent, respectively.²

Economics of tobacco use and tobacco control

• Missouri received $260.6 million (estimated) in tobacco settlement payments and taxes in fiscal year 2018.⁴
• Of this, the state allocated $48,500 in state funds to tobacco prevention in fiscal year 2018, just 0.1 percent of the Centers for Disease Control and Prevention’s annual spending target.⁴
• Smoking-caused health care costs: $3.03 billion per year⁴
• Smoking-caused losses in productivity: $3.04 billion per year⁵

Missouri tobacco laws

Tobacco taxes

• Missouri is ranked 51st in the U.S. for its cigarette tax of 17 cents per pack (enacted August 1993) compared to the national average of $1.73. (Connecticut and New York have the highest tax at $4.35 and Missouri has the lowest at 17 cents.)⁶ ⁷ ⁸
• All other tobacco products are taxed at 10% of the manufacturer’s invoice price.⁶ ⁷

Clean indoor air ordinances

• Smoking is prohibited in schools (public schools only) and childcare facilities.⁷
• Smoking restrictions are required in government workplaces, private workplaces, restaurants, retail stores and recreational/cultural facilities.⁷
• There are no smoking restrictions for bars or casinos/gaming establishments.⁷

Youth access laws

• The minimum age of sale for tobacco products in Missouri is 18.⁷
• Minors are prohibited from buying nicotine delivery products, including e-cigarettes.⁶

Local tobacco laws

• Fifteen municipalities, including St. Louis County and Kansas City, have prohibited the sale of tobacco products to people under age 21.⁹
• St. Louis prohibits the use of smokeless tobacco products at all sports venues, including Busch Stadium.¹⁰

Quitting statistics and benefits

• The CDC estimates that 49.0 percent of daily adult smokers in Missouri quit smoking for one or more days in 2016.¹¹
• In 2014, the Affordable Care Act required that Medicaid programs cover all tobacco cessation medications.⁷**
• Missouri’s state quit line invests 48 cents per smoker, compared to the national average of $2.10.⁷
• Missouri does not have a private insurance mandate provision for quitting tobacco.⁷

Notes and references

Updated June 2018

* National and state-level prevalence numbers reflect the most recent data available. This may differ across state fact sheets.

** The seven recommended cessation medications are NRT gum, NRT patch, NRT nasal spray, NRT inhaler, NRT lozenge, Varenicline (Chantix) and Bupropion (Zyban). Fiore MC, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: US Department of Health and Human Services. Public Health Service: May 2008.

1. CDC, Behavioral Risk Factor Surveillance System, 2016.
2. CDC, Youth Risk Behavior Surveillance System, 2017.
3. CDC, State-Specific Prevalence of Tobacco Product Use Among Adults - United States, 2014-2015, MMWR.
4. Campaign for Tobacco-Free Kids, Broken Promises to Our Children: a State-by-State Look at the 1998 State Tobacco Settlement 19 Years Later FY2018, 2017.
5. Campaign for Tobacco-Free Kids, Toll of Tobacco in the United States, 2018.
6. American Lung Association, SLATI State Reports, 2017.
7. American Lung Association, State of Tobacco Control, 2018.
8. Campaign for Tobacco-Free Kids, State Cigarette Excise Tax Rates & Rankings, 2018.
9. Campaign for Tobacco-Free Kids. States and Localities that have Raised the Minimum Legal Sales Age for Tobacco Products to 21. 2018; https://www.tobaccofreekids.org/assets/content/what_we_do/state_local_issues/sales_21/states_localities_MLSA_21.pdf.
10. Knock Tobacco Out of the Park.  https://tobaccofreebaseball.org/.
11. CDC, Behavioral Risk Factor Surveillance System, State Tobacco Activities Tracking and Evaluation System, 2016.