tobacco age in usa limit now 21 across US for cigarettes, products Minimum Age to Buy Tobacco:

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In short order, nearly half the adult population smoked

The total cost of treatment and costs due to inability to work due to illness and premature deaths for 5 out of 25 groups of diseases caused by tobacco was VN24 trillion

J Coastal Res 23:421428 Parker TT, Rayburn J (2017) A comparison of electronic and traditional cigarette butt leachate on the development of Xenopus laevis embryos

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Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms