There isn't much higher short term cost for a smoker. Lung cancer is generally fast and untreatable.
Were that the only smoking related medical snafu, you'd have a point; As it isn't the case, you don't.
Emphysema, poor circulation (requiring operations to improve blood flow, medication, and potentially amputation), gum shrinkage, COPD, heart disease (again, meds, ops, replacement organs), cataracts, and fibrosis, to name some of the others.
Speaking as the son of an 80 a day smoker, there is plenty of expense to the state accruing to the smokers tab (see what I did there!) not just the eventual cost of lung cancer treatment. Dad paid in more cig duty than most smokers before he quit, but he's sure not cheap to keep running - worth every bit as far as I'm concerned, obviously.