Objectives: To determine whether the cost of a statewide smoking cessation program in Pennsylvania could be justified by the benefits. Methods: A cost-benefit analysis of statewide access to smoking cessation programs. We compared three treatment alternatives, both with and without counselling: nicotine replacement therapy, bupropion and varenicline. Results: While the retail price of a pack of cigarettes in Pennsylvania is on average US$4.72, the combined medical costs and productivity losses in Pennsylvania attributable to each pack of cigarettes sold are approximately US$23.78 per pack of cigarettes. The ratio of benefits to cost varied from US$0.97 to US$2.76 saved per dollar spent on smoking cessation programs, depending upon the type of intervention. Conclusions: For most smoking cessation treatments, the benefits of a statewide smoking cessation program in Pennsylvania would greatly outweigh its costs.