THE STATE’S hospitals and doctors and public health groups and insurance companies and business community and advocates for the poor came to the State House last year demanding that lawmakers increase the cigarette tax to the national average, and use the money to shore up Medicaid, which provides medical care for the poor and disabled.

The group had the support of 68 percent of the public — and of a majority of the people who would pay the higher tax. It included nearly every major constituency in the state. And it had all the logic in the world on its side.

But the demand was unacceptably audacious: This was the first time in nearly two decades that anyone had mounted a serious, sustained effort to convince our tax-averse Legislature to raise any kind of tax. The money was to support the working poor, who aren’t exactly a favored group at the State House. And the proposed tax was on cigarettes, in a state where tobacco is still king, even though it no longer does much to justify that title.

So the Legislature decided to teach this impudent group a lesson. But it wasn’t the lesson legislators had in mind.

In rejecting the pure logic of the argument, the Legislature taught this Cigarette Tax For Health Care Coalition that when the objection flows from a religious opposition to taxation, all the logic and all the public support and all the political muscle in the world doesn’t mean a thing.

It was a tough lesson, one that left coalition members scratching their heads for some time. As strategist Rick Silver explained during a recent meeting with our editorial board: “It’s been questioned, if you couldn’t do it last year with all that, what do you do? Well, the one thing that we know is you can’t quit. And a lot of them think they can outlast us. But we’re not going to go away.”

Instead, the group is back with a new message. It still includes the irrefutable logic: Hospitals have no choice legally but to provide medical care to the poor, whether Medicaid pays for it or not; if Medicaid pays, the federal government picks up 75 percent of the cost; if Medicaid doesn’t pay, the hospitals pass the cost on to insurance companies, which pass it on to businesses in higher rates for medical insurance; so we all win if the state fully funds Medicaid.

But now the message also directly counters the “fairness” argument the opponents built their opposition around, and in so doing adds an emotional appeal to the logic; and it will be delivered to legislators’ front doors.

The fairness argument is that it’s not fair to balance the Medicaid budget on the backs of smokers. It’s an amazingly easy argument to counter, but one that wasn’t addressed directly enough last year. This year’s campaign corrects that error with a vengeance, turning it on its head with ads that show men and women and children and the words, “I don’t smoke, but I am paying for cigarettes,” and that show a cigarette and the question, “Are you sick of getting burned?”

Then the argument: “Whether you smoke or not, you pay for cigarettes. For every pack of cigarettes sold in South Carolina, your family, your employer and your state government spend $6.52 for health care. In fact, the average South Carolinian spent an additional $485 in state and federal taxes last year because of smoking.”

Talking points the coalition will distribute to the 92,000 South Carolinians in the medical profession, as well as business people and others who will be sent out to talk to their legislators in their neighborhoods, add that the $6.52 per pack comes to more than $850 million per year that South Carolinians pay in higher taxes, higher insurance premiums and higher medical charges. And the most direct link between the cigarette tax and Medicaid: Last year, the state government spent more than $118 million to treat illnesses caused by smoking, but collected only $25 million in cigarette taxes.

Last year, the message was delivered in Columbia, by lobbyists and coalition-generated mail, e-mail and phone campaigns. Many legislators dismissed it as a faux campaign, drummed up by a high-priced public relations group and a few businesses that stood to benefit from the change, but with no real grass-roots support. People who want a higher cigarette tax don’t live in my neighborhood. legislators told themselves.

This year, the campaign will be focused on legislators’ hometowns, so there’s no getting around where the cigarette tax supporters live. The coalition plans to hold meetings at hospitals, where doctors and nurses will tell their local legislators that they’re tired of paying the cost for cigarette smoking. It will be plastering cars with bumper stickers showing a cigarette-puffing pink piggy bank and the message: “Make Cigarettes Pay Their Fair Share.”

It still won’t focus enough on the most important message: that higher cigarette taxes mean fewer kids start smoking, and fewer kids become lifelong addicts, and fewer kids have to suffer from lung cancer and emphysema and depression and anxiety disorders and early and painful deaths.

Coalition members worry that this message might be too emotional, and too close to home.

Ms. Scoppe can be reached at cscoppe@thestate.com or at (803) 771-8571.