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and being the last, will, in the nature of things, vacate every former agreement inconsistent with it For it being a plan of government received and ratified by the whole people , all other forms, which are in existence at the time of its adoption, must yield to it This is expressed in positive and unequivocal terms, in the 6th article, That this constitution and the laws of the United States, which shall be made in pursuance thereof and all treaties made, or which shall be made, under the authority of the United States, shall be the supreme law of the land

Because your life will never, ever be the same and you have to prepare for that financially, emotionally, psychologically

Keller, P

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Example : A physician note states: Patient has smoked one pack per day for 15 years