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Key costs include: Annual health care costs directly caused by smoking in Tennessee: $2.67 billion Medicaid costs caused by smoking in Tennessee: $823.6 million Residents state and federal tax burden from smoking-caused government expenditures: $1,035 per household Smoking-caused productivity losses in Tennessee: $3.59 billion The Health Impact of Tobacco and Vaping in Tennessee Tobacco use has significant health consequences for Tennesseans: 32.9% of cancer deaths in Tennessee are attributed to smoking

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Shields, in Columbus, says in the past he found it very hard to understand why adults who should know better would continue to smoke, but his research on tobacco and addiction changed his outlook