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States Measured by Progress on Tobacco Control, Access to Care and Prevention

Missouri is falling short on its legislative work to combat cancer, according to a new report by the American Cancer Society Cancer Action Network (ACS CAN). How Do You Measure up?: A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality evaluates each state’s activity on issues crucial to winning the fight against cancer. The report by ACS CAN, the advocacy affiliate of the American Cancer Society, finds that Missouri measured up to benchmarks in none of the 10 measured areas.

“State legislators must take action on laws and policies that help people fight cancer by emphasizing prevention, making health care affordable, curbing tobacco use and prioritizing quality of life,” said Stacy Reliford, ACS CAN. “Missed opportunities to pass laws fighting and preventing cancer could limit state revenue and health savings, but could also limit the potential for saving countless lives from a disease that will kill 13,000 Missourians this year.”

How Do You Measure Up? grades 10 key state policy areas nationwide: breast and cervical cancer early detection program funding; tanning bed restrictions for minors; physical education time requirements; smoke-free laws; tobacco prevention program funding; tobacco taxes; improved access to Medicaid; policies to prevent and treat pain and access to palliative care.

A color-coded system classifies how well a state is doing. Green shows that a state has adopted evidence-based policies and best practices; yellow indicates moderate movement toward the benchmark and red shows where states are falling short.

The report also offers a blueprint for effective legislation on matters such as effectively implementing the Affordable Care Act for cancer patients and their families

How Missouri Measures Up:

Smoke-Free Law red

Tobacco Tax and Price Increase red

Tobacco Tax Increase Rates red

Tobacco Prevention and Cessation Funding red

Indoor Tanning Bed Restrictions for Minors red

Physical Education Time Requirements red

Breast and Cervical Cancer Early Detection Funding red

Effective Pain Policy yellow

Access to Palliative Care yellow

Medicaid Expansion red

“As advocates, we have a duty to inform the public about ways to prevent and treat cancer, but our voice is not enough if state and local policymakers don’t take action to fund and implement policies and programs that we know work,” said Reliford. “The best solutions will save lives and possibly millions of dollars in health care costs, and in many cases, it would cost Nebraska little or nothing to do the right thing.”

National Outlook

Nationally, the report finds that 38 states have reached benchmarks in only three or fewer of the 10 legislative priority areas measured by ACS CAN. Only 12 states and the District of Columbia met between four and six of the benchmarks. No states met the benchmarks in seven or more of the 10 policies measured by the report.

Since the first issue of How Do You Measure Up? was published 11 years ago, states have made tremendous progress toward implementing laws and policies that help fight cancer. In that time, 47 states increased their tobacco taxes more than 100 times and 24 states implemented comprehensive smoke-free laws covering bars, restaurants and workplaces. Since being established in 1991, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) has served more than 4 million low-income and uninsured women and provided more than 10 million screening exams. During the past six years, 26 states and D.C. have passed oral chemotherapy fairness legislation, improving patient access to anti-cancer oral drugs and five states have passed comprehensive laws to prohibit the use of indoor tanning devices by those under the age of 18. No state has met the benchmark for physical education time requirements. Thirty six states require less than 90 minutes of physical education per week.

States are working on implementing new insurance market rules required under the Affordable Care Act (ACA), including consumer-based health insurance marketplaces and policies that ensure access and affordability of prescription drugs that can improve patients’ quality of life. States are also considering whether to accept funds that the federal government has allocated to increase access to health coverage to hard-working adults and families through state Medicaid programs. To date, nearly half of all states have decided to accept the funding and many more states will continue to grapple with the decision into the 2014 legislative sessions.

Public health advocates continue to fight for smoke-free laws and regular and significant increases in state tobacco taxes, with a growing emphasis on tax parity for other tobacco products such as cigars, roll-your-own and smokeless.

In 2013, it is estimated that more than 1.6 million people in the United States will be diagnosed with cancer and more than 580,000 people will die from the disease. In Missouri this year, 34,000 will be diagnosed with cancer and another 13,000 will die of the disease.

To view the complete report, visit

ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit