[subungual]

Not here to proselytize about your lifestyle choices, and I've certainly enjoyed my fair share of smoking and drinking myself over the years. That said, as someone who works daily with patients whose health has been destroyed by excessive drinking or pretty much any level of smoking, it's always been striking to me how surprised people tend to be by the results.

A lot of people performing the calculus of "eh, what's five to ten years off the end of my life as long as I'm enjoying it now" seem to think it works neatly like that-- they'll die earlier from cancer or a heart attack, and that's it. I'm struck by how often they are surprised and upset by the fact that instead of that, they're living the last 30 years of their lives with irreversible heart, lung, liver, and vascular issues that leave them unable to do the things they've enjoyed outside of smoking and drinking. Just a thought.

[gitfan86]

The problem with the people you are talking about is that they didn't cut back as soon as they started to have minor medical problems. Having 4 drinks a day for a couple years in your 30s doesn't cause permanent liver damage that will kill you. But continuing to have 4 drinks a day AFTER being told that you are overweight and have elevated blood test results due to drinking can kill you.

This becomes even more important as you age. Someone who starts smoking heavily in their 60s is far more likely to get a blood clot than someone in their 20s

[subungual]

I fully understand what you're saying, but it's somewhat skew to the point I'm trying to make. The people I'm talking about are the ones who have already baked health effects of their habits into their calculus and claim to acknowledge them. For someone who has already bought into the idea that their smoking or drinking will shorten their lives, an elevated BP reading, finding themselves having trouble taking more than one flight of stairs, or even having some chest or leg pain when they're walking around are unlikely to be major wake-up calls. My point is that people may know the end result, but they generally don't have a sense of what the path to that result looks like and underestimate its effects.

[SketchySeaBeast]

I think that's assuming a lot about people to be able to quit cold turkey and being able to adequately identity the first sign of health issues. They've been dealing with health issues from their choices this whole time - if you're smoking you have a cough and your hands and teeth are yellowing, if you drink you wake up feeling like crap, so drawing the line at "as soon as they started to have minor medical problems" isn't really clear-cut. When is it a few extra pounds and when is it a beer gut?