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Proposition 10 raised the tax rate from 37 cents to 87 cents per pack,[179] and the MSA raised nationwide cigarette prices by nearly $250 billion over the next 25 years, or approximately 45 cents per pack.[180] The federal government then raised its rate 15 cents, first by a dime in January 2000 and then by a nickel in 2003, bringing the federal tax to 39 cents.[181] In 2006, California voters defeated Proposition 86, which would have increased the tax per pack from 87 cents to $3.47, the highest tax in the nation.[182] The combined effects of state and federal tax hikes during the past decade have made casual and commercial smugglers willing to skirt the law

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While not many laypeople would read the Journal of the American Medical Association, more scientific reports finding ever stronger evidence of the link between smoking and cancer began to be reported in the popular press

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