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In a statement, Sharpless noted that tobacco use is still the leading cause of preventable disease and death in the U.S. He said it kills more people each year than alcohol, HIV, car accidents, illegal drugs, murders and suicides combined. Sharpless added that the FDA remains committed to educating the public, especially Americas youth, about the dangers associated with using cigarettes and other tobacco products. The agency said that over 16 million Americans alive today live with disease caused by cigarette smoking. It added that tobacco use also costs more than $300 billion a year in direct health care costs and lost productivity. First Amendment court battle This is not the first time FDA officials have tried to add graphic images to tobacco warnings