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).

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).

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)