By Cindy Schroeder
The Cincinnati Enquirer

Patricia Hoover-Ebersole has struggled for years to kick her pack-a-day smoking habit.

Northern Kentucky health officials and a statewide anti-smoking coalition of health-related groups soon hope to give the 42-year-old Independence woman the incentive she needs. They're part of a growing statewide movement to curtail public smoking and stop youths from starting.

What makes Kentucky's anti-smoking efforts so unusual is the fact they take place in a state where burley tobacco is about a half-billion-dollar-a-year cash crop raised in 119 of 120 counties. The commonwealth also boasts the highest adult smoking rate in the nation.

However, in the past year, the Philip Morris tobacco company has pulled its manufacturing plants out of Kentucky. The number of organizations opposing the most recent attempt to hike Kentucky's cigarette tax has declined. And non-smokers, armed with growing information on the harmful effects of secondhand smoke, are increasing the pressure on local and state lawmakers to restrict public smoking.

"Societal attitudes about smoking are definitely changing," said Kathy Gavin, director of health education and planning for the Northern Kentucky Independent District Health Department. "People are speaking up more about issues like secondhand smoke, and they have a better understanding of the ill effects of smoking. At the very least, it's becoming a public health issue.''

KY. SMOKING RATES

• Adults: 30.5%, the highest rate in the United States. • High school students (grades 9-12): 37.4%, the fourth highest rate in the United States. • Middle school students (grades 6-8): 21.5%, the highest rate in the United States.

Among the recent changes:

• On Wednesday, the Northern Kentucky health board adopted a resolution encouraging local officials to enact laws to restrict smoking in public places, especially where minors are likely to gather.

• Kentucky ACTION, the Louisville-based Alliance to Control Tobacco In Our Neighborhoods, announced this week that it's launching a campaign to boost the state's cigarette tax by 75 cents when the General Assembly convenes in January.

• Last month, a group of teens dedicated to fighting substance abuse called for Covington to follow Lexington's lead and restrict smoking in most public buildings. Leaders of the second-largest city in the state voted to ban smoking in most public buildings, effective Sept. 29.

• Northern Kentucky now has 69 smoke-free restaurants. Last November, 20 local restaurants went smoke-free for a day, as part of the National Great American Smokeout observance, and organizers expect the number of participating restaurants to grow this year. Non-smoking advocates say restaurant, bar and casino workers are exposed to secondhand smoke levels that are 300 to 600 percent higher than other occupations.

Health of citizens

"The message is finally getting through to our legislators,'' said Paul Kiser, ACTION's manager of advocacy and education. "We can still be a tobacco state but at the same time, take steps to improve the health of our citizens.

TOBACCO EXCISE TAX

• Kentucky's tax: 3 cents, the second lowest behind Virginia's 2 cents; national average is 72.9 cents; Ohio's is 55 cents and Indiana's is 55.5 cents. • Impact on smoking: A 10% increase in cigarette price results in an overall 4% drop in smoking rates and a 7% drop in smoking rates for pregnant women and youths • A 75-cent increase would reduce smokers by 43,000, saving more than 9,000 lives. • Smoking's cost to state of Kentucky • $3 billion worth of economic liability annually. Of that, $1.17 billion is in direct heath care costs and $380 million is paid by all taxpayers through the Medicaid program. Another $1.84 billion is in lost productivity from premature death and long-term disability. • Annual cost to average Kentucky household to treat smoking-related health problems: $502 Source: Kentucky ACTION, Louisville anti-smoking group

"When Lexington, in the heart of burley country, passed its ban by a vote of 11 to 3, that caught a lot of people by surprise,'' he said.

Increasing the cigarette tax by 75 cents would raise more than $300 million in new revenue in a state that's struggled with budget deficits as high as $700 million, Kiser said.

A growing number of Kentucky legislators, including state Sen. Dan Kelly, a Springfield Republican who had maintained a hike in the cigarette tax wasn't necessary in the past, now are willing to consider some sort of cigarette tax increase, anti-smoking advocates say.

One vote they won't have is that of state Rep. Royce Adams, a Dry Ridge Democrat.

"If the federal government gives the farmer a buyout, that's a different story,'' Adams said. "But I don't see that happening.''

Adams, a non-smoker, said that he's raised tobacco all his life and represents a district with a lot of smokers. His district also includes Owen County, one of the most tobacco-dependent areas in the state.

Hoover-Ebersole said tighter restrictions on public smoking coupled with an increase in Kentucky's cigarette tax would likely force her to quit her 31-year habit. If it cost more to buy cigarettes, I would probably quit,'' she said.

E-mail cschroeder@enquirer.com