Kind of a tangent but I think a big part of the explanation for declining life expectancy is hiding here in plain sight.

Since everyone knows smoking is bad for a long time now, we’re going to eventually need to categorize stuff like lung-cancer as a death of despair, similar to other deaths caused by alcoholism, opioids, or suicide.

A lot of people who otherwise might quit smoking are probably looking at impossible dreams of home ownership or retirement, and thinking consciously or unconsciously that there is more dignity in a death at 50-60ish than one at 80ish when you’re unemployable and the thin promises of social safety nets have fallen through.

Smoking (or other high risk activities) might be a dirty habit but it’s still more socially acceptable than suicide.