JEFFERSON CITY - Missourians are more likely to smoke than Americans in all but two states, and with the defeat of Proposition A they'll continue to get relatively cheap cigarettes for the foreseeable future.
Despite the fact that the proposal fell just 30,000 votes short of passing in Tuesday's election, opponents and some allies of the tax increase say the issue is probably dead for the time being.
Sen. Marvin Singleton, R-Seneca and chairman of the public health and welfare committee, laughed at the suggestion that the legislature would pass a tobacco tax increase when it reconvenes in January.
Singleton, a physician, proposed an increase in the cigarette excise tax last spring and said he was dismayed that none of his fellow Republicans voted in favor of it. With Republicans now firmly in control of both houses of the legislature, prospects for tobacco tax funding for health care grow dimmer.
He credits the strength of the tobacco lobby with blocking higher tobacco taxes.
"It's a very powerful special interest that does not hesitate to reward their friends or punish their enemies," he said.
Singleton credited Missouri Right to Life with playing a deciding role in the campaign. The group came out in opposition to the tax, saying the increased health care funding could be used to fund abortions.
The senator said a mass mailing from Right to Life sent out just before the election may have been decisive in altering the votes of the Republican base, already energized by Jim Talent's campaign for U.S. Senate.
A representative for Missouri Right to Life could not be reached for comment.
Despite the defeat, Brad Ketcher, director of the group that proposed the amendment, refused to rule out another campaign in 2004.
"The health care needs [that] this tried to address won't go away," he said. "There is still a need for prescription drug access and to protect our kids from tobacco."
Ketcher blamed the state in part for the measure's defeat. Missouri Secretary of State Matt Blunt kept the measure from being put on the ballot in August due to concerns over signatures on the petition. That decision was overturned in September by a judge in Cole County.
"We had a very limited amount of time to run a campaign," he said. "We had to litigate with the state to get this on the ballot and really only had about six weeks."
Ketcher also credited a "disinformation campaign by the tobacco companies and tobacco retailers" with spreading fears that the tax would not be used for health care.
Ronald Leone, a lobbyist for a group of Missouri convenience stores who campaigned vigorously against the tax, said the hospitals and business groups that backed the well-financed proposal might think twice about supporting it again.
"I think it's a great day for Missouri that $5 million can't turn a bad idea into a good idea," he said. "The reason it was so close was that they had $5 million. If I had the resources that they had it wouldn't have even been close."
He said fears that the money would be misused were well grounded.
"We've already received $500 billion in tobacco settlement money since 1998, none of which has gone to address the evils of tobacco," said Leone.
One striking aspect of the vote was the sharp divide between rural and urban voters on the issue. Morgan Mundell of the Community Policy Analysis Center at the University of Missouri said the proposition ran into much stronger anti-tax sentiment in outstate Missouri than in urban areas. Counties in southeastern Missouri had especially high numbers of votes against the ballot issue.
Leone also attributed the opposition in outstate Missouri to rural voters recognizing that they wouldn't see the benefits of the tax increase.
"The people that stood to gain from the proposition passing, primarily HMO's, doctors groups, hospitals, and drug companies are located in those urban areas," he said.
Missouri has the tenth lowest cigarette tax in the country, and the defeat of Proposition A runs counter to national trends. This year alone, twenty other states as well as the federal government have raised cigarette taxes.
Only Kentucky and Nevada have a higher percentage of smokers than Missouri, Mundell said.