Defense Department officials have expressed concern that the smoking problem is impacting the U.S. military’s readiness for battle, and the tobacco-related cost from health problems and lost days at work among soldiers and veterans has been estimated to be in the billions.

Roughly 40 percent of cigarettes sold in the U.S. are smoked by people with mental health issues, including depression, anxiety or substance-abuse problems.

“As the number of smokers drops, the industry is finding it harder and harder to find those replacement smokers,” Koval said in an interview. “So the industry is targeting people based on their challenges in life, on who they are. It’s shocking and appalling.”