This article was produced by Kaiser Health News, a national health-policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.Each time over the past decade or so that New York state increased its tobacco tax \u2014 now at $4.35 per pack of cigarettes \u2014 calls to the state\u2019s Quitline spiked.And as high as the state tobacco tax went, in New York City, then-Mayor Michael Bloomberg hiked the tax even more.\u201cI was so angry with him, I could hardly afford it,\u201d says Elizabeth Lane, a Harlem resident who paid $12 a pack. \u201cI had to beg, borrow and steal to get money to buy cigarettes.\u201dAt first, Lane cut down to four packs a week from seven. But even so, she sometimes didn\u2019t have money to buy laundry detergent or toilet paper. Then in 2013, after smoking for 40 years, the price tag, her doctor\u2019s warnings and her daughter\u2019s guilt trips all came together.She quit.\u201cI said, \u2018Lord, I\u2019ve been waiting a long time for this. When will you answer my prayer?'\u201d she says. \u201cAnd he answered this time.\u201dFour states will vote on whether to raise their tobacco tax in November: California (by $2), Colorado ($1.75), North Dakota ($1.76) and Missouri (15 cents). California currently has one of the lowest cigarette taxes in the country: 87 cents per pack. If voters pass Proposition 56 in November, the tax would go up to $2.87 a pack. Backers of the measure, including the American Cancer Society and the American Lung Association, hope to hit people hard enough in the wallet that they quit smoking, or never start.Studies support the goal. For every 10 percent increase in the price of cigarettes, smoking goes down 4 percent, according to a 2014 report on smoking by the U.S. surgeon general.\u201cPart of that is people quitting. Part of that is people cutting down,\u201d said Stanton Glantz, a professor of medicine at University of California, San Francisco and director of the Center for Tobacco Control Research and Education.In New York City, smoking rates declined from 22 percent of adults to 13 percent in the 12 years after the tax, and a ban on smoking in restaurants and bars, was implemented.California\u2019s smoking rate is about 12 percent, the second lowest in the country after Utah. Most people in California who do smoke, Glantz said, don\u2019t smoke that much.\u201cIt may be that a price increase that will follow Prop. 56 will be enough to just get these light, intermittent smokers to just say, \u2018Forget it,'\u201d he said.Behavioral economist Justin White, a colleague of Glantz\u2019s, said the vast majority of smokers wish they could quit. They know it\u2019s bad for them. But addiction is a powerful force.\u201cThere\u2019s this universal tendency toward immediate gratification,\u201d White said.The craving for a cigarette right now easily overwhelms fears of heart disease or lung cancer in the future. But, White said, a cigarette tax that is high enough can flip that. A tax evident at the time of purchase has the power to compete with the desire for a cigarette.\u201cIncreasing taxes is a way to really bring that back to equilibrium, the cost in the future versus the benefits now,\u201d White said.The question is, how much. He said a $1 or $2 tax is enough to sway smokers with a mild self-control problem. But for smokers with a strong addiction, the tax needs to be between $5 and $10 to work.Either way, White said, a tax is most effective when paired with support from a cessation program.And this is where opponents have been digging into Proposition 56. The \u201cNo on 56\u201d campaign, backed by tobacco companies R.J. Reynolds and Philip Morris, has raised $56 million to defeat the measure. Supporters have raised $17.5 million.Opponents are investing in radio ads that say proponents \u201care telling us Proposition 56 is all about helping people stop smoking. But follow the money, and you\u2019ll find out that only 13 percent of the new taxes would actually help people quit.\u201dThis is true. Of the $1.4 billion that Proposition 56 is expected to raise from the tax, 13 percent would go to the state\u2019s cessation programs. The rest of the tax money would go to Medi-Cal, the state\u2019s low-income health care program, which covers care for one in three Californians.But UCSF professor Glantz said that $100 million for smoking-cessation programs is enough money to fully serve all would-be quitters who need help.Opponents ultimately reject the tax, no matter how the revenues would be spent.\u201cI\u2019m opposed to every manner of taxing,\u201d said Steven Greenhut, Western Region director for the R Street Institute, a free market think tank that promotes limited government. \u201cLet people make their own choices.\u201dHe doesn\u2019t like that Proposition 56 would tax e-cigarettes, too.\u201cVaping is not entirely safe,\u201d he said. \u201cBut it\u2019s pretty clear that vaping is far less harmful than smoking.\u201dEarly studies suggest that e-cigarettes may have fewer health effects than cigarettes. Still,in a proposal to regulate e-cigarettes that became effective in August, the Food and Drug Administration said that some studies have found toxic material in e-cigarette liquid and the exhaled vapor. But, the agency said, \u201cwe do not have sufficient data to determine what effects e-cigarettes have on public health at the population level.\u201dIn any event, Greenhut said it\u2019s premature to tax e-cigarettes.For Elizabeth Lane in New York, the nicotine patch was her ticket to quitting. Now, she no longer huffs and puffs when she walks.\u201cI can walk up stairs. I don\u2019t cough,\u201d she says. \u201cAnd the circulation in my legs has improved.\u201dShe says now she saves the money that she used to spend on cigarettes so she can buy birthday and Christmas presents for her daughter and granddaughter.\u201cInstead of being on the receiving end all the time, you know, give me, give me, give me,\u201d she says, \u201cI can give now.\u201dThis story is part of a partnership that includes NPR, KQED, WNYC, NPR and Kaiser Health News. WNYC\u2019s Fred Mogul contributed to this report.