Smoking & Tobacco Use: Extinguishing the Tobacco Epidemic in New Jersey. Cigarette smoking remains the leading cause of preventable death and disability in the United States, despite a significant decline in the number of people who smoke.Over 16 million Americans have at least one disease caused by smoking. This amounts to $170 billion in direct medical costs that could be saved every year if we could prevent youth from starting to smoke and help every person who smokes to quit.