I think Harry has had a good stab at some figures. Even if the smoker only smoked 20 per day for only 25 years - that's a sizeable stack of cash. Of the few smokers who end up in ICU, I think they have quite comfortably paid for that bed and all their other treatment. Every case is different though. Some will go instantly with a heart attack - others may linger for a lot longer. The fact that can't be contested is that smokers have funded their treament, even before savings on pensions are factored in.