Individuals should pay for their own bad choices. Im in Aus and a pack of smokes last year (yesterday) cost $28. Today $35. thats for 25 cigarettes. Taxes work. In america it's a little more tricky, and nailing down the cause of long term conditions is also tricky.

But if you're fat, smoke and don't do anything, and then you have a heart attack its kind of easy to link things together.