They're a lot poorer now, and so they have less money to spend on healthy food. So not only are they destroying their health by smoking, they're stuck eating crappy food as well.
https://www.statista.com/statistics/434150/share-of-canadian...
I don't believe though that this is inevitable, and I hope that the first world will continue to improve its situation, and that less well-equipped areas will somehow avoid making the mistakes and leapfrog these uncomfortable middle periods. We see this for instance with the Industrial Revolution, where those that can be credited with facilitating it generally did pretty poorly for themselves, but those who industrialised later were substantially better off.