New York City officials approved legislation last month hiking the per-pack price of cigarettes to $13, while South Carolina's cigarettes remain among the most affordable in the nation.
Experts in this state believe the relatively low cost in South Carolina presents a public health problem. Research has proven that raising the cigarette tax decreases the smoking rate.
"It’s one of the most effective deterrents for smokers," said Catherine Warner, outreach coordinator for the Tobacco Control Network, run by the S.C. Department of Health and Environmental Control.
Decreasing the smoking rate was the impetus for the measure approved by New York Mayor Bill de Blasio on Aug. 28. About 900,000 people in New York City are smokers. De Blasio's wants at least 160,000 of them to quit by 2020.
Meanwhile, in South Carolina, 19 percent of the population smokes, and the minimum cost for pack of cigarettes is about $4 or $5. The state's tax is only 57 cents a pack, the 45th-lowest tax of all states, according to the Campaign for Tobacco-Free Kids. The lowest tax in the country is in Missouri, where cigarette buyers pay just 17 cents in taxes per pack.
South Carolina legislators last increased the state's cigarette tax in 2010 by 50 cents, overriding a veto from then-Gov. Mark Sanford. Before the 2010 increase, it had been 33 years since the last cigarette tax hike was approved here.
According to DHEC, though, about 73 percent of the South Carolina population supports higher cigarette taxes. Some state lawmakers recently suggested raising the cigarette tax as a way to address the looming pension fund crisis.
Sen. Darrell Jackson, D-Hopkins, said such a tax is one option he'd like the General Assembly to consider. Rep. Bill Herbkersman, R-Bluffton, was also among lawmakers who endorsed the idea. But Jackson said many of his colleagues have taken pledges to not increase taxes, so pushing an additional tax through would be a challenge.
"I'm for whatever it takes to fix the system," Jackson told The Post and Courier last year. "It's going to take money that we don’t necessarily have right now."
Cigarettes are highly addictive in nature — Warner, the DHEC expert, said they're more addictive than even heroin — and when smoked regularly, will kill half of all long-term smokers, according to the Food and Drug Administration.
The FDA recently announced a plan to reduce the nicotine in cigarettes, rendering them less addictive. Tobacco companies' shares immediately dropped following the FDA announcement.
Dr. Michael Cummings, a Medical University of South Carolina researcher, is co-leader in a research project investigating the impact of government policy on vaporized nicotine products, such as "e-cigs."
He said the FDA is also conducting studies on how e-cigs may play a role in smoking cessation. Cummings is hopeful e-cigs, which some studies have shown may help users to wean off cigarettes, may help solve South Carolina's persistent smoking problem.
The most important effect of raising the tax is to make cigarettes less attractive to a non-smoker, he said. If teenagers are given the choice between a pack of Marlboros or the price of a movie ticket, for example, they might choose the movie instead.
A federal tax on cigarettes was last approved during President Barack Obama's first days in office in 2009, when it rose from 39 cents to $1.01 per pack.
But taxes on tobacco products haven't changed the fact that tobacco companies still post big profits. Profit margins have increased 77 percent since 2007, according to The Wall Street Journal.
In June alone, 22.8 million cigarettes were produced in the United States, according to the Department of Treasury. Each one costs pennies to make, Cummings said.
"It’s like printing money," he said.
Cummings, who previously worked in New York, also spearheaded the creation of New York's "quitline."
South Carolina's quitline is an important resource to those wanting to kick their cigarette addiction, Warner said. She said smokers are three times more likely to quit smoking if they combine help from the quitline and cessation options like nicotine patches or gum.
Since the passage of the Affordable Care Act, such options are now more commonly covered by insurance. Dr. Matthew Madden, a Trident Health internist, said he has seen those options become more affordable to his patients.
Still, he said, it is an ongoing struggle. Smoking is difficult to tackle when it is accepted within a person's social circles, he said. So he focuses on encouraging entire families to quit.
This summer, South Carolina's Medicaid program expanded its coverage for cessation medications. Many are now available without a copay or prior authorization.
"That’s opened up cessation techniques to thousands," Warner said.
The most important efforts still lie in making cessation options available, and in making smoking less acceptable, particularly when it comes to impressionable teenagers.
Warner said she has seen cigarette smoking become less socially acceptable in recent years, "and that's what we want."