Much of what we do in primary care is prevention. We diagnose and manage hypertension, reduce cholesterol, optimise diabetes care, and initiate anticoagulation in atrial fibrillation. All of these are preventative interventions in patients who are largely asymptomatic. By embracing these preventative activities, we endorse them as a worthwhile use of clinician time. Preventative treatment of diabetes and hypertension rarely extends to treating the underlying cause, however, and behavioural risk

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... factors in people without "comorbidity" to prevent the onset of disease are even less likely to be tackled. Half of all smokers will die prematurely, 52% of cancer deaths are attributable to smoking, 1 and obesity can reduce life expectancy by 10 years. 2 While good progress was made in reducing smoking prevalence in the past few decades, prevalence has stalled at around 15%, 3 and the prevalence of excess weight rose during the pandemic with two thirds of UK adults now overweight or obese. 4