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Impact of Tobacco in West Virginia: The Need to Invest in Tobacco Control to Reduce Taxpayer Costs, Protect Kids, and Save Lives:   Health Costs of Tobacco to West Virginia Tobacco is an addictive and deadly product. Smoking harms nearly every organ in the body and remains the ... deaths are caused by smoking.   Economic Costs of Tobacco to West Virginia Smoking is estimated to cost West Virginia $1.17 billion in direct health care costs, including $298.1 million in Medicaid costs annually.v Additionally, smoking costs the state $2.4 billion in productivity costs ...