[bell-cot]

> ...some nebulous fear of illness decades in the future...

Old guy's perspective: Most of the family / friends / neighbors who I knew to be regular cigarette smokers 3-4 decades ago are now either dead, or suffer profoundly reduced qualities of life - generally due to lung cancers & other stereotypical "smoker's diseases". Not a random sample, and the value of n is too small to call it solid statistics, but...

[cafard]

It is fair to say that the prospect of lung cancer in one's 60s or bladder cancer in one's 70s is not going to impress every eighteen-year-old.

They are difficult to quit. My father took a good dozen years to quit, with repeated failed attempts. During one of the big takeover battles of the 1980s, somebody explained the desirability of owning a cigarette manufacturer: you make them for a dime, you sell them for a dollar, and people get addicted to them.

[bell-cot]

> ...not going to impress every eighteen-year-old.

Quite true. OTOH, I know a guy who was still a heavy smoker in his early 50's. Plenty to live for - corporate V.P. & rising, great girlfriend, his kids getting out of college.

If he had any interest in quitting, it was a well-kept secret.

~8 years later: After a few not-quite-good-enough attempts, his oncology team found a chemotherapy drug toxic enough to kill the lung cancer that had spread all through his body. Faced with "or die", and missing his oldest daughter's wedding day, he signed off on the side effect. Those were as advertised: He now lives in a hospice, and needs to a couple good, strong caregivers to safely get out of bed. On a good day. "Never really there for him" is a pretty accurate description of how well his brain is working, too.