The nation's battle against smoking and its many health-related perils has had more ups and downs than a patient fever chart: Tobacco revenues go up, but government spending on antismoking programs declines, as smoking rates creep up.
The challenge is to drive those numbers in the right direction to improve public health.
But on the heels of the first reported increase in smoking in a decade - driven mostly by younger smokers - comes a study documenting that states see the benefits of antismoking programs and are trying to maintain funding.
Pennsylvania unfortunately was singled out as one of the states making large cuts last year in antismoking efforts amid the budget crisis, according to the study, done for the American Heart Association and other health advocacy groups.
That's the wrong path to take on such a key public-health issue, especially at a time of record revenues from tobacco taxes and continuing payouts from the 1998 tobacco settlement. Moreover, the growing number of states with indoor smoking bans provides a golden opportunity to piggyback antismoking efforts so that more people quit.
Just under 21 percent of all adults smoke, representing about 46 million people. That's up from nearly 20 percent in 2007.
So it's at least good news that one New England state serving as a testing ground for the near-universal health care being debated in Congress is documenting remarkable success in cutting smoking by its poorest residents.
By providing low-cost smoking-cessation treatments to Medicaid recipients, Massachusetts health officials cut smoking rates in this population by more than 25 percent.
The steep drop from 38 percent of poor Massachusetts residents smoking to about 28 percent last year - representing 30,000 fewer smokers - is impressive proof that concerted antismoking efforts can have a big payoff.
A few states offer Medicaid recipients stop-smoking benefits; good to see Pennsylvania among them. But so far only Massachusetts officials report such an impressive drop in smoking among Medicaid recipients.
The state offers low-income smokers up to six months of counseling and access to smoking-cessation medications. That sort of aggressive approach may account for their success.
Among smokers in general, their cessation efforts frequently fail the first few times. As the old joke goes, quitting must be easy since so many smokers have done it over and over again.
With more teens and young adults acquiring the deadly habit every year - in large part, due to the industry's $12.5 billion annual ad budget - the price of slacking off on antismoking efforts is steep. Some 440,000 Americans die annually from smoking-related illnesses, a toll in human suffering as well as a drag on the nation's economic prospects with associated health-care costs and lost productivity.
As Congress looks for ways to tame health costs, it would be wise to include new Medicaid coverage for antismoking efforts. Meanwhile, state health officials would be smart to replicate the Massachusetts effort by extending stop-smoking initiatives to as many citizens as possible.