Smoking costs in California are nearly $16 billion annually, or $ 3,331 per smoker every year, according to a report by the UCSF School of Nursing Institute for Health & Aging. The healthcare costs alone would equal one-quarter of the projected state deficit, according to Wendy Max, PhD, co-director of the Institute for Health & Aging and UCSF professor of health economics. “Our study shows that even though tobacco control efforts in California are among the most successful in the nation, the cost of smoking in the state continues to increase,” said Max. “These numbers should be a wake-up call that we need to continue our efforts to reduce the health care costs, lives lost, and pain and suffering caused by smoking.”