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Missouri is not doing enough to reduce cancer deaths, according to a new report.

The Show Me State was labeled as “falling short” in most categories in the American Cancer Society report called, “How Do You Measure Up?”

State legislators could implement solutions in the report and fight back against cancer, according to the ACS.

But State Rep. Dave Hinson, R-St. Clair, said it is not the government’s job to legislate every aspect of people’s lives.

Below is a breakdown of some areas Missouri is falling short on, according to the report:

Cigarette Taxes

Missouri has the cheapest cigarette taxes in the country at 17 cents per pack.

By increasing taxes on tobacco products, states can save lives, reduce healthcare costs and generate revenue, the report says.

Hinson said there was a ballot initiative a couple of years ago to raise the cigarette tax and it failed overwhelmingly. He does not see the cigarette tax changing.

The average cigarette excise tax is $1.54 per pack, nationally, with the highest being $4.35 per pack in New York.

Smoke-Free Laws

Secondhand smoke causes approximately 42,000 deaths each year in the United States among nonsmokers, the report says.

Missouri is one of 14 states that does not have a statewide smoke-free law for any of the following types of venues: non-hospitality workplaces, restaurants and bars.

The city of Washington recently passed a smoke-free law, but the Franklin County Commission has been reluctant to move forward with a countywide law.

Hinson said he sees smoke-free laws as more of a local issue. Moreover, he said hospitals and government buildings are smoke free. But he does not think the government should tell private property owners whether to allow smoking. It is up to the consumers whether they want to patronize businesses, he added.

Tobacco Prevention Funding

Missouri spent $76,364 on tobacco prevention in fiscal year 2014, when the Centers for Disease Control recommended the state spend $72.9 million. That means the state spent only 0.1 percent of what the CDC recommended, the study adds.

But Hinson said he thinks the message that smoking causes health problems is being disseminated on TV and in schools. He said he does not know what else the state can do, adding that it is still a free country.

Indoor Tanning

The Missouri Legislature passed a bill this year to require written consent from a parent or guardian for minors under 17 to use an indoor tanning facility.

Despite the new law, the report still found that Missouri is falling short in this area. States with an outright prohibition on tanning bed use for children under 18 were noted as “doing well” in this area of the report.

Laws that prohibit the use of indoor tanning facilities for people under 18 can reduce cancer incidence and mortality, the reports says.

Hinson said he thinks the new Missouri law is fine.

Skin cancer is the most commonly diagnosed form of cancer in the United States.

Physical Education

Missouri was also said to be falling short in physical education requirements for students. According to the report, Missouri requires less than 90 minutes per week of physical education or no physical education at all. Being overweight or obese can increase cancer risk, the report adds.

Expanding Medicaid

Missouri’s decision to not expand Medicaid has resulted in the state falling short in improving access to care, the report says.

Some people are now in a “coverage gap” because Missouri has not expanded Medicaid. The coverage gap includes people who do not qualify for Medicaid, make too little to receive federal subsidies for private insurance and cannot afford insurance in the private market.

Hinson said Medicaid should first be reformed to root out waste, fraud and abuse rather than just throwing more money at the problem.

An estimated 193,000 people in Missouri under the federal poverty level fall in the coverage gap, the report says.

Tobacco Rating

The Affordable Care Act allows insurance companies to charge smokers up to 50 percent higher premiums than nonsmokers. This can price smokers out of insurance and prevent them from obtaining the needed cessation services, according to the report.

States can reduce or eliminate the penalty that charges higher premiums for smokers. Some states have done so, but Missouri continues to allow the surcharge of up to 50 percent on tobacco users’ premiums.

Breast and Cervical Cancer Early Detection

The report said Missouri is falling short in this area, too. If detected early, breast cancer has a 99 percent survival rate and cervical cancer can be prevented by removing lesions found during screenings. Survival rates for those cancers plummet with late detection.


Missouri showed progress in a few areas of the report, including providing Medicaid coverage for tobacco cessation.

Missouri provides at least one type of counseling (individual or group) and one tobacco cessation medication for Medicaid enrollees.

Pain control policy is another area where Missouri showed progress. States face challenges when it comes to creating policies that make pain medications available to patients while at the same time keeping them out of the hands of people who misuse them, the report states. Missouri should repeal restrictive or ambiguous policy requirements and adopt additional positive policy, the report adds.

Access to care that improves the quality of life, including relief from pain and stress, for cancer patients is another area where Missouri showed improvement.