The self-appointed nannies among us remind me of Mister Mackie on "South Park": "Since I have never taken drugs, I know they have nothing to offer."
There's a reason that tobacco is (arguably) the second-most popular psychoactive drug, after alcohol. It is a mood leveler. If you're a little nervous, it calms you down. If you're a little depressed, it peps you up. And the beauty of this is that you don't have to be enough in touch with your own feelings to even know which way you need to go!
Hundreds of millions of people self-medicate with tobacco. Probably billions, considering the usage rates in eastern Asia and all of the former Soviet Union. The world would be an even crazier place without it.
Yes I understand the risks, and no, I don't smoke. But risk analysis/management is complicated, which is why most people (including obviously Billy T) don't understand it at all. If you ask the average crappy-feeling person if he would be willing to continue feeling crappy much of the time, every day for the rest of his life, so that his life will be longer and he'll have many more years to feel crappy, what do you suppose he would say? After he finished laughing?
Sure, here in the West there's a psychotherapy industry. Have you ever undergone psychotherapy? If you had, you'd know that most of the time it doesn't work, and even when it does it takes many years to feel better. And it costs a fortune. For much less money you can feel much better, much sooner.
If you're concerned about the cost of medical care for these people, then you're arguing against socialized medicine. Let people buy their own health insurance, and the insurance company will charge them much higher premiums if they smoke. If they can't afford the insurance and can't afford to pay their own medical bills, well then I guess they'll die. Of course they might die first due to a road accident, a random shooting in a movie theater, a terrorist attack, bird flu, high cholesterol, or a spouse who caught them cheating.
Tobacco is not simply an addiction. It's pleasure. Let people have their little pleasures. The self-appointed nannies just don't get that. In fact it's been said that they can't sleep at night, worrying about the fact that somebody, somewhere, is having a good time.