in the 1990s it was an issue that we pretty much agreed that cigarette smoking induced terminal disease and also instead of universal healthcare America routed its welfare state through employers but also this “Medicaid” charity-case program which was kind of coopted from state programs which were kind of expanded from a tradition of county programs which were kind of inherited from the parishes of the Catholic Church back in the English Reformation

but the result of all this was now that we had better healthcare for this shit than pointing and saying “you’re gonna die” governments at every level felt politically obligated to provide and thus pay out the nose for it and were ticked

except the areas of the country that grew tobacco were in a specific slice of the southeast that was right in the process of switching party alignment in a narrowly balanced Congress so no one could afford to press them at the federal level

that was the last time I can remember where an important national issue was decided/had political impact on lines of geography rather than ideology

(the issue was settled extracongressionally through a legal settlement in something like a multi-state class action that at least violated the spirit of the Interstate Compact Clause)