teichflamme,

I think uncertainty plays a big role here.

You could bump a line and smoke a pack a day and get to 90.

You could do nothing harmful and die at 30.

Even if you make it to 90 avoiding lots of fun, was it worth it or would you rather trade 20 years for more fun?

At the end of the day it is a matter of personal risk tolerance towards an impossible to quantify risk.

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