Missouri Highlights

Tobacco use remains the leading cause of preventable death and disease in the United States and in Missouri. To address this enormous toll, the American Lung Association calls for the following actions to be taken by Missouri's elected officials:

During the 2025 legislative session, Missouri lawmakers passed an appropriations bill that funded the tobacco prevention and control program at $5.2 million, which is a 72% increase from last year's funding level. This is due in no small part to the efforts of legislative champions in the House and the Senate who advocated for a funding increase to the tobacco use prevention program.

Three pieces of legislation that would preempt stronger local tobacco product licensure and/or sales regulations were introduced. The bill that advanced the furthest included preemption of local tobacco product sales with a carveout to allow existing local Tobacco 21 ordinances to be enforced by local authorities. Thanks to a coordinated effort among our health partners and key legislators, these preemptive policies did not advance further.

Additional legislation was introduced to:

• set up an e-cigarette directory based on U.S. Food and Drug Administration pre-market tobacco application status;

• repeal state preemption on local tobacco tax increases upon community voter approval;

• strengthen the Missouri Clean Indoor Air Act by removing current exemptions for casinos, bars, restaurants, etc., and add marijuana to the act.

However, none of these bills advanced this session.

During 2025, in Kansas City, a flavors ordinance was filed that would prohibit the sale of all flavored tobacco products. Despite a strong sponsor and coalition supporting the measure, there were not enough council votes to approve it.

During 2025, a smoke-free indoor air policy with narrow exemptions (Tarkio), and two smoke free park policies (Salem and Noel) were put in place.

The Missouri Department of Health and Senior Services Tobacco Prevention and Control Program (MO TPCP) provided training, technical assistance, and resources to 324 schools/districts to help enhance their current tobacco-free campus policies.

Missouri Tobacco Quit Services provided services to 4,170 people, a significant increase from previous years.

During the 2026 legislative session, the American Lung Association in Missouri will continue to work with public health partners to sustain tobacco control funding and maintain Quitline services and other vital programs provided by the MO TPCP given the future uncertainty of federal CDC funding. The Lung Association will continue to educate state lawmakers and community members on the issue of preemption and encourage them to avoid supporting legislation that takes away the rights of local communities to pass policies to protect their citizens from tobacco. The Lung Association will also support local and state laws to provide comprehensive protections from secondhand smoke in public places and workplaces.