Smoking. Estimated annual cost: $157 billion. The tab includes $75 billion in direct medical expenses, with the rest in lost productivity from ill patients missing work. Given the low-tax (or no-tax) underground cigarette economy on the Web and on Indian reservations, it's unlikely that sales and usage have dropped much over the past decade, official government statistics notwithstanding.
Drugs. Estimated annual cost: $110 billion. Like alcohol, illicit drug use is more prevalent among the unemployed. Most addicts are also heavy drinkers, though only a small minority of alcoholics are drug abusers. Crystal meth has followed marijuana, cocaine and heroin as the drug of choice among the young set.
Overeating. Estimated annual cost: $107 billion. Overeating increases the risk of many health problems, including heart attacks. Obesity causes 14% of attacks suffered by males and 20% of those suffered by females, the National Institutes for Health says, and fewer than a third of adults get regular exercise. The bulk of the $107 billion is the direct cost to treat heart disease, osteoarthritis, hypertension, gall bladder disease and cancer.
Gambling. Estimated annual cost: $40 billion. Addicted gamblers often feel compelled to chase after bad bets with more money in the hope of winning back their losses. And some who catch the fever develop the need to periodically raise the betting stakes to keep the same thrill. Also, addicts often face job loss, bankruptcy and forced home sales, and they are at greater risk to commit crimes like forgery and embezzlement.
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