There are already a huge number of safety regulations on cars that have significantly reduced the death rate due to auto accidents over the last few decades despite the fact there are many more cars on the road. If guns were regulated to the extent that cars are, you would only have a fraction of the type of guns on the market that we do now. I am not saying we should regulate guns like we do cars, but rather I am just pointing out that its a bad comparison.
Personally, I think health insurance rates and medicare taxes should be higher for smokers to reflect the actual costs they place on the system. Basically, if you want to smoke then fine, but if the actuaries decide that you should be paying twice the health insurance rates and twice the medicare rates, then so be it. That is true with a lot of health choices though. No other insurance works like health insurance. For example, if you are a bad driver and get into lots of accidents and get lots of tickets, you will be paying a significantly higher auto insurance rate than a contentious driver. However, you can be morbidly obese, smoke two packs a day, and still pay the same health insurance rate or medicare rate as a vegetarian triathlete. What was particularly deplorable prior to the ACA is that someone born with something like Cerebral Palsy would be practically uninsurable in the private sector while someone that by their own choices in life was obese and a smoker could get health coverage easily.