A review of the literature was undertaken, exploring the tremendous economic burden that cigarette smoking places on the United States. The cost of medical care and lost productivity related to smoking is conservatively estimated to be $150 billion. These costs to smokers and non-smokers alike are funded at the state and national levels. The literature supports the idea that the single most important barrier to smoking cessation is the cost of medications and smoking cessation programs. In this article, it is proposed that millions of smokers could be assisted to quit by federal government intervention alone. A federal tax on cigarettes could fund smoking cessation in federal insurance programs and provide incentives for private insurers to do the same.