To Accelerate Smoking’s Decline, New York Needs Pragmatic Tobacco Taxes
New York has been a leader in public health over the years. When it comes to ending cigarette smoking, however, the job is far from finished.
Nearly 1.6 million New York adults still smoke cigarettes, and more than 28,000 New Yorkers die each year due to smoking. Cigarette use is tied to more than a quarter of cancer deaths statewide and costs more than $12 billion annually in direct healthcare spending.
With such a staggering toll, tobacco tax policy should be about more than revenue. The way we tax nicotine products can either encourage adults who smoke to move away from cigarettes or unintentionally keep them there. That’s why Governor Kathy Hochul’s proposal to raise taxes on nicotine pouches deserves closer scrutiny.
Not all nicotine products are the same. Cigarettes burn tobacco and create smoke, which causes most smoking-related illnesses, including COPD and lung cancer. Noncombustible products, including nicotine pouches, expose users to far fewer toxicants and are considered significantly lower risk than cigarettes. After a rigorous scientific review, the U.S. Food and Drug Administration authorized several nicotine pouches for sale, determining they are “appropriate for the protection of public health” and can benefit adults who switch completely away from cigarettes.
Today, cigarette use in New York is concentrated in working-class and economically disadvantaged communities, among people living with mental health challenges, and among veterans. Most people who smoke want to quit. While traditional cessation strategies, including tobacco quitlines, can improve success rates, fewer than 1 in 10 people who attempt to quit remain smoke-free long term. Many adults are therefore turning to lower-risk nicotine alternatives to transition from smoking.
Tax policy should reflect this reality. Risk-based taxation is grounded in a simple principle: products that pose less potential harm should cost less. Maintaining meaningful price differentials creates a financial incentive for adults who smoke to transition away from cigarettes, which remain uniquely lethal. Narrow the price gap, and you weaken that incentive.
I’ve spent much of my career working in tobacco prevention and control, including serving as Director of the New York State Bureau of Tobacco Control. I’ve seen what works and what doesn’t. Abstinence-focused cessation strategies have not been sufficient to meet the needs of the many New Yorkers who want to quit smoking. Tobacco harm reduction is an evidence-based approach that can accelerate smoking cessation and deserves support from policymakers.
No nicotine product is without risk. But policy should acknowledge differences in risk and ensure every practical tool is available to help people move away from cigarettes. Making lower-risk alternatives affordable and accessible gives more adults who would otherwise continue smoking a greater chance to quit.
New York has long led the nation in tobacco control. True leadership now means targeting the product that causes the overwhelming share of death and disease: cigarettes. They should remain the most expensive and least attractive option. If we are serious about ending tobacco’s toll, tax policy must align with science and recognize that risk is not the same across products.
Dr. Jeffrey Willett, a tobacco and nicotine policy expert, formerly served as the Director of the NYS Bureau of Tobacco Control and a National Vice President at the American Heart Association. He currently serves as Director of the Project to End Smoking for the Progressive Policy Institute.
