Yet smoking rates are higher and sugar-substitute use is much lower in European countries with a higher life expectancy. The keys, IMHO:
(1) Active lifestyle — a lot more people commute on foot or by bike
(2) Portion control
(3) Lower levels of stress. 50 hr work weeks combined with 3 hr/day commutes are much less common.
BTW, outside of CA, indoor smoking in restaurants and bars was allowed well into the 2000s. NY banned it only in 2003, NJ waited till 2005 or 2006 to outlaw it. It’s still legal indoors in bars in Pennyslvania.
As far as sugar substitute use, it’s not clear that most substitutes are any healthier than sugar itself, when used in moderation (since they tell the body to expect a load of sugar while not delivering, confusing the pancreas). And if anything, since a lot more sugar comes from HFCS than it did 20 years ago, we may be worse off now.