Cardiovascular disease, cancer, chronic obstructive lung disease and diabetes (all chronic diseases) make up the vast majority of deaths and disability in the country. Chronic disease is more prevalent in Eastern Canada, and as a nation we are in the throes of an epidemic of these diseases.   Cardiovascular disease is the leading cause of death in Nova Scotia and in Canada.   Each year cardiovascular disease costs the Canadian economy $7.3 billion in direct costs (medical care, hospitalization, drugs, research) and $12.4 billion in indirect costs (lost wages, decreased productivity).   In 1991, smoking-related health care costs were $2.5 billion (Can). Additional smoking-attributable costs included $1.5 billion for residential care, $2 billion due to worker absenteeism, $80 million due to fires and $10.5 billion due to lost future income caused by pre-mature death. These costs can be reduced - through health promotion and chronic disease prevention initiatives.