INDIANAPOLIS (AP) — Two new reports say opioids and tobacco claimed the lives of 14,200 Indiana residents last year, costing $12.6 billion in health care expenses, lost productivity and other economic damages.

The studies by the Richard M. Fairbanks Foundation recommend that Indiana raise its cigarette tax by $2 a pack and increase the legal smoking age to 21. The studies also suggest expanding access to syringe exchanges and safe disposal sites for opioids.

The reports come after Republican leaders in the Indiana House earlier this year blocked a bill that proposed increasing the legal age for buying tobacco products from 18 to 21.

The reports acknowledge Indiana has seen a steep decline since 2011 in fatal overdoses involving prescription opioids, but say there’s been a rapid rise in the synthetic opioid fentanyl.