LOUISVILLE, Ky. (WDRB) – For the last decade, Cathy Anderson has tried to help people in northeastern Kentucky’s Boyd County quit smoking or not start using tobacco at all.

The county seat, Ashland, bans smoking in workplaces and other public spaces. And all three of the area’s public school systems have tobacco-free campuses.

But the adult smoking rate of 21 percent remains higher than the national average of about 15 percent, as is the case across the state. At 25 percent Kentucky has the second-highest share of adult smokers in the U.S., trailing only neighboring West Virginia.

“I want jobs here. I want my kids to stay here,” said Anderson, a registered nurse who oversees Boyd County’s tobacco cessation program. “When it comes to this area looking attractive, we’re not – and it’s because of smoking.”

Other states have sought to cut smoking rates by raising taxes on cigarettes. Anderson and the Ashland-Boyd County Health Department favor that approach – as does a new, wide-ranging collection of more than 100 Kentucky organizations.

Formed last month, the Coalition for a Smoke-Free Tomorrow is taking aim at the state’s high smoking rate, pressing for higher cigarette taxes and urging local officials to enact smoke-free ordinances. The goal: Make Kentucky healthier and reduce the state’s cancer rate – the highest in the U.S.

The coalition wants the state General Assembly to pass legislation adding at least $1 to a per-pack tax on cigarettes that now stands at 60 cents and was last raised in 2009. That increase would generate more than $266 million for the state each year, according to estimates.

In addition, the coalition also plans to push more Kentucky fiscal courts to enact comprehensive smoking bans for enclosed spaces and workplaces. Only four of Kentucky’s 120 counties -- Jefferson, Hardin, Woodford and Fayette -- have passed such ordinances.

“If we can do those two things, the smoking rate in the Commonwealth of Kentucky will go down, and the cancer rate in the Commonwealth of Kentucky will go down,” said Ben Chandler, the coalition’s chairman. “And I can’t think of anything more important than that.”

Such attempts are not new. But the effort unveiled this fall seeks to align high-profile business and health groups at a time when Kentucky faces a funding shortfall of up to $84 billion for the state’s public pension systems.

The two largest business organizations in the state – Greater Louisville Inc., the metro area chamber of commerce, and the Kentucky Chamber of Commerce – are among the smoke-free coalition’s backers. Both previously have supported hiking cigarette taxes.

Since Republicans wrestled control of the Kentucky House of Representatives from Democrats in 2015, joining the GOP-led Senate, the state chamber has successfully championed a legislative agenda that has included allowing charter schools and creating panels to evaluate medical malpractice claims. It spent more lobbying lawmakers this year than any other group.

In surveys, 90 percent of the chamber’s members have backed a cigarette tax increase and support for smoke-free workplaces, said Ashli Watts, the Kentucky chamber’s senior vice president of public affairs.

“We think that now is the appropriate time to really take a serious look at raising the cigarette tax,” she said, especially in light of the state’s pension crisis and calls for broad tax reform.

Chandler, a former Kentucky Attorney General and Democratic member of the U.S. House of Representatives, said it’s “very important from a political standpoint” that the state chamber is on board.

Meanwhile, it’s a “no-brainer” for the Louisville-area chamber to support efforts to decrease smoking, spokeswoman Alison Brotzge-Elder said.

“We want a healthy workforce. Now in economic development, the health and knowledge of your workforce is the most appealing incentive to attract investment into your community,” she said.

Smoking costs Kentucky $2.79 billion in lost productivity each year based on smokers’ deaths alone, according to data cited by the coalition. That doesn’t include other sick days and other workplace costs related to smoking illnesses.

To help blunt those costs, state Sen. Stephen Meredith said he will introduce a bill for the 2018 legislature that would add at least $1 to the price of cigarettes. But he insists he is not proposing a tax.

Instead, it’s a “health care reimbursement assessment” that would send 90 percent of the proceeds to offset costs of treating smoking-related illnesses incurred by the state’s Medicaid program, said Meredith, a Leitchfield Republican and the retired CEO of the Twin Lakes Regional Medical Center.

“One of the things we can do to control costs is to make people accountable for their own health,” he said.

The bill envisions charging $1.50 more per pack in counties that don’t have comprehensive smoking bans, Meredith said, acknowledging that would include the six counties he represents.

Kentucky has twice raised its cigarette tax since 2000. But among neighboring states only Missouri, at 17 cents per pack, has a lower rate than Kentucky’s 60 cents, according to data compiled by the Campaign for Tobacco-Free Kids, one of the coalition’s backers.

State Rep. Mary Lou Marzian, D-Louisville, sponsored a bill during the 2016 session that sought to increase the state cigarette tax by 60 cents per pack. It died in the House budget committee.

She attributed the legislature’s past reluctance to boost cigarette taxes to “a final holding on with their fingernails to tobacco in Kentucky.”

A tax increase would affect big tobacco companies, but it could force some small retailers to close or lay off workers, said Billy Grantz, partner and owner of Cox’s Smoker’s Outlet and Spirit Shoppes. He said Cox’s had a 20 percent decline in cigarette sales when the state’s last cigarette tax passed.

“I think it’s going to hurt small business more than anything else,” Grantz said. “And it’s going to hurt the pocketbook of the blue-collar smoker that’s probably going to continue to smoke some way or another. To me, it’s a poor person’s tax more than anything else.”

The Kentucky Retail Federation hasn’t taken a position on any proposed cigarette tax increase. “We’ve just chosen not to engage on this issue,” said Sarah Rowlette, the federation’s communications director.

The Kentucky House narrowly voted for a statewide ban in 2015, but the bill died in the Senate. The coalition’s goal is for enough counties to enact their own ordinances and create momentum for a new push by state lawmakers.

More than 20 local health departments in the state, along with the Kentucky Health Departments Association, have signed on to the coalition. Among them is the Bullitt County Health Department, which enacted a countywide smoking ban in 2011 that the Kentucky Supreme Court voided in 2014, ruling the board “exceeded its authority.”

Since then, Bullitt’s fiscal court hasn’t considered passing a ban, magistrate Dennis Mitchell said.

“I haven’t heard anybody say anything about it,” Mitchell said. “I don’t think it really matters at this point. I don’t want to take anyone’s liberty away from them.”

But the overwhelming majority of public places in the county, such as restaurants, have chosen to go smoke-free, said restauranteur Tom Chamberlain, who co-owns the Lights Out Bar and Grill in Shepherdsville and the Lights On Bar and Grill in Mount Washington with his wife, Beth Ann.

Chamberlain, a smoker, said both of his restaurants prohibit smoking.

“If we allowed smoking,” he said, “we wouldn’t have half the business we have.”

Reach reporter Marcus Green at 502-585-0825mgreen@wdrb.com, on Twitter or on Facebook. Copyright 2017 WDRB News. All rights reserved.