Petition measures must “speak with clarity and precision, and not sow confusion and doubt,” the judge wrote in her ruling.

Zellweger also said the petitions were legally flawed because they included a proposed ballot summary. In doing that, she said, proponents were able “in a form that appears to be official” to seek signatures without the need for signers to review the full text also on the petitions.

A county ordinance assigns the county counselor’s office to write the summaries that actually go on the ballot.

The judge’s ruling leaves on the St. Louis County ballot a separate proposal that would restrict smoking to no more than half of casinos’ gaming floors. Current law exempts all of the gaming floors.

That measure had qualified via a rival petition drive funded by Penn National and was aimed at giving county voters an alternative to the health groups’ proposal.

Moeller, the Maryland Heights mayor, called the judge’s decision “the fair thing to do” and that it would keep Hollywood on a level playing field with the nearby Ameristar Casino in St. Charles. His legal fees were paid for by Penn National, he said.

Ben Murray, an official with the health coalition, said “we are looking at all of our options.”