Comprehensive tobacco control policies a key step in reducing Missouri’s high tobacco use rate

Clear smoking disparities exist statewide across racial, cultural and socioeconomic lines

Missouri has one of the highest statewide smoking averages in the country, more than 23 percent. And racial and ethnic minorities, people with lower incomes and education levels, Medicaid recipients and the LGBT community smoke or experience secondhand smoke at a rate significantly higher than the state average.

These findings are highlighted in a recent report by the Center for Tobacco Policy Research (CTPR) at Washington University in St. Louis. The report, “Who is Most Affected? Tobacco-Related Disparities in Missouri,” identifies statewide differences related to who is smoking, who is exposed to secondhand smoke and who is quitting.

The report is based on analysis of the 2007 Missouri County-Level Study of Adult Tobacco Use and Related Chronic Conditions and Practices, the largest special survey ever undertaken by the Missouri Department of Health and Senior Services.

A total of 49,513 Missouri adults were interviewed for the study. The county-level study was supported by a grant from the Missouri Foundation for Health as part of its Tobacco Prevention & Cessation Initiative (TPCI).

CTPR also found that Medicare recipients have the lowest level of confidence in their ability to quit smoking. More than 34 percent of the Medicare recipients who participated in the county-level study do not believe they can successfully stop smoking, a rate much higher than the state average of 20.7 percent.

Douglas Luke, PhD, CTPR director and professor at the George Warren Brown School of Social Work at Washington University, says the tobacco industry has a long history of targeting at-risk and vulnerable groups with its advertising.

“Addressing these groups as part of our comprehensive tobacco control efforts in Missouri will help reduce the overall burden from tobacco use, making Missouri a healthier place,” Luke says.

The new disparities report recommends the following tobacco control efforts for Missouri:

  • Implement comprehensive, population-level tobacco control policies such as increasing the tobacco excise tax and mandating 100 percent clean indoor air policies.
  • Address the need for affordable, accessible and relevant cessation services, particularly for those groups disproportionately affected by tobacco use.
  • Tailor health messages to make sure they are culturally relevant and easily understood by targeted groups.
  • Continue assessing tobacco-related behaviors across the state and make improvements to future statewide surveys as needed.

Nancy Mueller, board chair of the statewide Tobacco Free Missouri coalition and associate director of CTPR, says communities across the state are acting to protect the health of their citizens.

“But we see from this report that unless our elected officials in Jefferson City take action, many populations will continue to face disparities in tobacco use and exposure,” Mueller says.

“Comprehensive tobacco control policies at the state level ensure the inclusion of all Missourians,” she says.

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