To the Editor Smoking remains one of the leading causes of preventable cancer deaths, and Lortet-Tieulent et al1 recently estimated that 28.6% of cancer deaths in 2014 can be attributed to cigarette smoking. Historically, state-based legislation and public health initiatives have been the most successful ways to reduce smoking. Some approaches include mass media antismoking advertising, smoke-free policies, smoking curricula in schools, restricting tobacco companies from marketing, raising the legal smoking age from 18 to 21, and raising the cigarette tax.2 Of these, the most promising strategy at the current time appears to be raising the cigarette tax.3,4 Each state (and the District of Columbia) sets its own cigarette tax, ranging from $0.17 for Missouri to $4.35 for New York, with a national average of $1.65 per pack.5 This is levied on top of a federal tax rate of $1.0066 per 20-pack of cigarettes.