Tl;dr be affluent enough to be able to afford great medical care and have enough free time for preventative actions
Giving out nicotine gum , would decimate the drugs industry, but likely resolve a lot of our chronic health and depression issues.
Is this not under-reported? I have known several people for whom smoking appears to be truly necessary. One said he was prescribed smoking to control his "shakes".
If you can get time off work and have a PPO, you can get the preventative care.