Cigarette smoking, the main way we take in nicotine, is the single greatest cause of preventable diseases (these are the progressive, serious diseases) and probably creates the most difficult addiction of the commonly used drugs. Smoking is a high-priced addictive pleasure (and sometimes displeasure) that is costly, not only in dollars but also in lives as well.

The estimated cost of smoking is somewhere between $50 and $100 billion a year. Some 650 billion cigarettes are sold yearly in the United States in this $18–25 billion mega-business. The 650 billion count averages about 4,000 cigarettes per year per person over age 18. Recentestimates suggest that about 38 percent of the over-18 population in the United States smoke. Percentages of adult smokers are even much higher in most European countries and some parts of Asia. In addition to the cost of the cigarettes, there are many billions spent medically to treat the problems that afflict smokers and many more billions in lost work and productivity caused from diseases generated by smoking.