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On average, federal and state excise taxes account for 44.3% of the retail price of cigarettes (CDC, Economic trends in tobacco , n.d.) Cost of Smoking-Related Illness Smoking-related illness in the United States costs more than $300 billion each year, including: more than $225 billion for direct medical care for adults, and more than $156 billion in lost productivity, including $5.6 billion in lost productivity due to secondhand smoke exposure