ROBERT SIEGEL, HOST:
In November, voters in four states will decide whether to raise their tobacco taxes. North Dakota is considering increasing its tax by $1.76 per pack of cigarettes. In California, the proposal is $2 a pack. But do those taxes actually help people quit smoking? For member station KQED in San Francisco, reporter April Dembosky went to find out.
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UNIDENTIFIED WOMAN: Thank you for calling the New York State Smokers' Quitline.
APRIL DEMBOSKY, BYLINE: New York has the highest cigarette tax in the country, $4.35 per pack. Each time it went up, calls to the State Quitline spiked.
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UNIDENTIFIED WOMAN: Quitting smoking can also save a lot of money in the long run.
DEMBOSKY: In New York City, Mayor Michael Bloomberg raised the tax even more.
ELIZABETH LANE: Oh, I was so angry with him. I could hardly afford it.
DEMBOSKY: Elizabeth Lane was paying $12 a pack.
LANE: I had to beg, borrow and steal to get money to buy cigarettes.
DEMBOSKY: At first, Lane managed to cut down from seven packs a week to four. But sometimes, she still didn't have money to buy toilet paper.
LANE: I asked my daughter, you got $50? What for? I need cigarettes.
DEMBOSKY: Finally, the price tag, her doctor's warnings, her daughter's guilt trips - it all came together. She quit. Studies show that for every 10-percent increase in the price of cigarettes, smoking goes down 4 percent.
STANTON GLANTZ: Part of that is people quitting.
DEMBOSKY: Stanton Glantz is a professor of medicine at UC, San Francisco.
GLANTZ: Part of that is people cutting down.
DEMBOSKY: California already has the second-lowest smoking rate in the country after Utah. Glantz says most people here who do smoke don't smoke that much.
GLANTZ: It may be - the price increase that'll probably follow will be enough to just get these light and intermittent smokers to just say, you know, forget it.
DEMBOSKY: Glantz's colleague, Justin White, is a behavioral economist. He says most smokers wish they could quit. But addiction is a powerful force.
JUSTIN WHITE: There's this universal tendency towards immediate gratification that people have.
DEMBOSKY: The craving for a cigarette right now easily overwhelms fears of heart disease or lung cancer in the future. But White says a cigarette tax that's high enough - at least a few dollars - can flip that.
WHITE: Increasing taxes is a way to really bring that back into equilibrium - the cost in the future versus the benefits now.
DEMBOSKY: But opponents of the tax say people should be free to make their own choices. Steven Greenhut is from the R Street Institute, a libertarian think tank.
STEVEN GREENHUT: Personally, I'm opposed to every manner of taxing.
DEMBOSKY: He doesn't like that some of these states would tax e-cigarettes, too. He says studies show that e-cigarettes pose fewer health risks - though, to what degree is actually unsettled. Either way, Greenhut says it's premature to tax them.
GREENHUT: Anything that makes it harder for people to try a safer alternative, I think, is harming public health.
DEMBOSKY: In New York, for Elizabeth Lane, the nicotine patch was her ticket to quitting and feeling better.
LANE: I don't huff, huff, huff when I'm walking.
DEMBOSKY: She's saving money, too.
LANE: Instead of being all on the receiving end all the time - you know, give me, give me, give me - I can give now.
DEMBOSKY: She says she can buy presents for her daughter and granddaughter. For NPR News, I'm April Dembosky in San Francisco.
SIEGEL: That story is part of a reporting partnership of NPR, KQED and Kaiser Health News.