Pennsylvania is among the states with the highest real cost of smoking for an average smoker, according to a new report from WalletHub.

To determine the true per-person cost of smoking in each of the 50 states and the District of Columbia, WalletHub calculated the potential monetary losses brought on by smoking and exposure to second-hand smoke.

These include the lifetime and annual cost of a pack of cigarettes per day, healthcare expenditures, and income losses.

The Keystone State ranked at No. 38 with an average lifetime cost per smoker of $2,539,086. This includes the out-of-pocket cost of $149,095, which puts the state at No. 40 overall, and the financial opportunity cost of $1,662,222, also ranking Pennsylvania at No. 40.

The healthcare cost per smoker in Pennsylvania is at $169,254, enough to be No. 32 on the list, and the income loss per smoker is at $548,320, which puts it at No. 28.

Meanwhile, the state has one of the lowest amounts of other costs per smoker at $10,194, which makes it No. 12 in the nation.

The total average cost per year per smoker is $52,898.

Read WalletHub’s entire report here.