The smoking rate in Canada is far lower than the United States, despite having universal healthcare. I think it's more cultural than financially driven (though aggressive taxation of tobacco could be a factor if that's a thing in the US, too).

Sources I can find suggest that Canada and the US are comparable (10% CA, 12% US). Your point is still valid that it's culture.

You both could be right.

Especially in places like NYC, cigs are very expensive.

Well, legal cigs. There is a healthy black market in NYC.

IIRC the difference when applying for insurance on the healthcare marketplace for 2023 was like $5/month (out of $700 total - so less than 1% more).

My employer plan charges $500/yr

That’s probably an exception. My understanding is that usually insurance companies charge MUCH more if you smoke.

Was trying to find out when it even became legal for insurers to even have a tobacco surcharge. That speaks to the power of the tobacco lobby.

I believe (iirc) that legality is quite recent (possibly from the ACA), but I'm pretty sure that is news within the last 20 years.

In that search, I spotted a study that stated the surcharge does not increase cessation but does decrease uptake. Which makes sense, tobacco has a higher relapse rate at 6 months than compared to relapse rates for cocaine or heroin.

High cig prices have a similar effect for youth smoking. Smoking is an infamous example of inelastic demand (that and gasoline were _the_ examples used when I was taught elastic vs in-elastic demand in grade school)