"A failure to fund Medicaid will cost us all," said Sue Berkowitz, executive director of the S.C. Appleseed Legal Justice Center and a member of the Cigarette Tax for Health Care Coalition.

"More than 70 percent of the people in this state agree with us," she said, referring to a study the coalition commissioned. "They have no problem using cigarette taxes to fund Medicaid. And it's time for the Legislature to do what the people want."

Berkowitz was one of the key speakers at Tuesday's meeting, held blocks from the Statehouse and sponsored by CTHC, a coalition of more than 100 state groups in favor of the cigarette-tax-for-Medicaid plan.

For the past two legislative sessions, the coalition has fought unsuccessfully to win legislators to their side, the most notable defeat coming last year when the General Assembly turned back a bid from Gov. Mark Sanford to lower the state income tax from 7 percent to 5 percent over 15 years and increase taxes on cigarettes from 7 cents to 53 cents a pack.

Despite the setback, many in the coalition say they were gaining support until last week's announcement from the governor's office.

For the upcoming legislative session, Sanford proposes cutting state income taxes by 15 percent and raising the taxes on cigarettes by 61 cents. The governor says the plan would provide about $222 million in immediate income tax relief and make the state more attractive to businesses.

But unlike his previous proposal, this tax plan does not earmark the money raised for Medicaid. This sudden change of direction came like a body blow to the coalition and led directly to Tuesday's meeting.

"We planned on doing this at some point in the year, but after the (governor's announcement), it was clear to us that we needed to get our message back out there," said Stephanie Jones, a coalition spokeswoman.

The message is simple: Cigarette smokers cost everyone in the state millions of dollars, and it's time they paid up. Coalition study numbers indicate:

-- Every pack of cigarettes sold in the state costs $6.52 in health care. This money is paid by everyone in the state, smokers and nonsmokers.

-- Every family pays an average of $485 in state and federal taxes to pay for health care related to smoking.

-- Nationwide, taxpayers footed $810 million in extra taxes, higher insurance premiums and higher charges at the doctor's office due to cigarettes.

-- South Carolina state government spent $110 million for health care costs related to smoking in 2002, but collected only $25 million in taxes from cigarettes.

"Smoking taxes everyone," says Tom Dandridge, coalition member and chairman of the S.C. Hospital Association. "Isn't it time to make cigarettes pay their fair share?"

Not everyone at Tuesday's meeting was overly concerned with using cigarette taxes to fund Medicaid. Renee Martin of the S.C. Tobacco Collaboration is in favor of a tax increase on cigarettes that would deter people from smoking.

According to Martin, a 6 to 10 percent increase in taxes on cigarettes would lead to a 6 to 10 percent drop in young people starting to smoke. The Collaboration advocates a 93 percent increase in taxes for cigarettes, which it says would result in 21.2 percent decrease in smoking.

Some local residents do not think paying a few more dimes for cigarettes will lead smokers to kick the habit. If Summerville resident Dan Howard had to pay an extra 61 cents to buy a pack of cigarettes, he would pay it.

"If lung cancer doesn't scare you, an extra 61 cents won't keep you away," said Howard while buying a pack of imported cigarettes Tuesday. He usually opts for Camels.

Tom Chatburn, the owner of Tinder Box Internationale in downtown Charleston, has made his living the past eight years by selling tobacco products. He was in business for one year before selling cigarettes. He did it, he said, to satisfy the smokers' market demand.

Based on the cost of cigarettes in California and New York, which may top $7 a pack, he does not think an increase in South Carolina will deter smokers.

And more than likely, because smokers will not quit smoking, the governor's idea will raise money for the state.

"It's a sin tax," Chatburn said. "It's an easy way for the state to get money because people are going to smoke. It is almost too good of an opportunity to pass up."

South Carolina's 7-cent tax on cigarettes is the fourth-lowest in the nation, and everyone agrees the state's Medicaid system is in dire shape. Estimated at about $180 million in debt, Medicaid was saved in the 11th hour last year by a one-time, $200 million federal bailout. It was made clear at the time that a similar measure would not be available this year.

Sanford has said his executive budget will fund Medicaid this year.

"The governor's goal is to not only deal with the short-term problems, but also the long-term need of getting people off the Medicaid rolls and into good-paying jobs," said Will Folks, Sanford's spokesman. "But he is committed to fully funding Medicaid through general fund dollars. Those are stable and can be applied to the federal match."

For every dollar the state puts toward Medicaid, the federal government adds $2.33.

The state faces a $350 million shortfall this year and is expected to dole out some tough cuts across the board. Some worry that this leaves Medicaid vulnerable and say the system needs to be funded by a secure, recurring revenue source.

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