It's a costly habit that could get even more expensive. Starting in 2014, the Affordable Health Care Act will allow insurers to charge smokers buying individual policies up to 50% higher premiums.
"I think it's one of those things where people make choices," said former smoker Barry Dalton. "Choices come with consequences, choices come at a cost."
Under the overhaul, insurers won't be allowed to charge more if you're overweight or have a health condition. But they can issue fees if you light up. Cigarette makers say the policy is discrimination.
"It's a lifestyle choice that we've made and I just think that's ridiculous having to spend more money like that," shared smoker Christopher Northington.
Nearly one in every five US adults smokes. That share is higher among lower income people who are also more likely to work in jobs that don't come with health insurance and would therefore depend on the federal health care law. It's something that worries the American Cancer Society.
In a statement they told 69 News: "Levying a surcharge on tobacco users could make health insurance unaffordable and prohibit them from getting either the medical help needed to break their addiction or the basic health care that we all need."
Smoking increases the risk of developing heart disease, lung problems and cancer. It contributes to about 450,000 deaths a year.
"If it helps people make that choice or think twice about it, it's probably worthwhile," added Dalton.
"Money has never been a reason why I've ever thought of quitting," explained Northington.
The American Lung Association of the Mid-Atlantic agrees, saying in part: "Punitive measures like tobacco surcharges have not been proven effective in encouraging smokers to quit and reducing tobacco use."
In the end, the battle could be up to each state. Under the law now, states have the power to limit the smoking surcharges or prohibit them all together.