As state officials open discussions about a new comprehensive transportation plan, the topic of additional toll roads has come up. Adding tolls to some highways is seen as an alternative to higher gasoline taxes, which officials want to avoid.

Charging people who use roads a “user fee” to pay for building and maintaining the highway system makes a certain amount of sense.

So if a user fee is an appropriate way to fund a transportation system, would it be valid to charge people who make greater use of the state’s health care system a user fee to help fund that system? Kansas Gov. Kathleen Sebelius announced this week that she would again propose adding 50 cents to the state tax on a pack of cigarettes to fund health care reforms, including helping low-income Kansans purchase private health insurance. Smoking generally increases how much a person uses the health care system, so a cigarette tax is about as close as you can get to a health care user fee.

The 50-cent cigarette tax got a negative reaction from state legislators last session and was rejected again this week by some legislative leaders. One of the main reasons they gave is that it would be a hardship for retailers living near the state’s borders. But how great would that hardship be?

Admittedly it would be an issue along the Missouri border, unless some special exemptions are granted. Kansas now levies a tax of 79 cents on a pack of cigarettes. Missouri’s rate is 17 cents, the lowest in the nation.

Nebraska currently charges an 80-cent tax on a pack of cigarettes; Colorado charges $1.05. Oklahoma raised its tax to $1.03 in January 2005. Interestingly, a study released by Oklahoma State University earlier this year confirmed that the 23-cent increase had a health benefit of its own. From fiscal year 2004 to fiscal year 2006, the number of cigarettes sold in Oklahoma declined by 47 million packs or about 13 percent. Some smokers might have been buying their cigarettes elsewhere, but about 35 percent of smokers surveyed said the price increase had encouraged them to quit, improving their own health and decreasing pressure on the health care system.

Kansas reportedly is one of only 10 states where the percentage of uninsured residents is on the rise. If Kansas legislators don’t have another plan to attack that problem, maybe they should at least look at a higher cigarette tax. If they think 50 cents a pack is too much, there appears to be some room to raise the Kansas tax but still keep it at or slightly below its neighbors to the south and west.

As for competition from Missouri, maybe there’s hope. Voters there turned down a proposal a couple of years ago to raise the state’s cigarette tax by 80 cents, but tight times might bring a proposal back to the table. Two years after Oklahoma’s $1.03 cigarette tax went into effect, Texas raised its cigarette tax by $1 a pack to $1.41. Given the health benefits involved, it might not be a bad trend for Kansas to feed.