Oh boy we could get into it. Medical sociologist (and alcoholic/drug addict) with a fondness for poststructuralism here. Ultimately, all our “choices” are constrained by cultural, economic, and socio-political forces. I would argue that it’s impossible to discern choice from social norm. In the context of substance use, for instance, most folks stop or try to stop not because drugs are inherently harmful (see Carl Hart’s work on this), but because the sanctions for drug use (stigma, loss of employment and housing opportunities, criminalization, drug toxicity derived from no regulation, etc.) are severe. If drug use was normalized and widely accepted, the treatment industrial complex would cease to exist (in part because far fewer folks would become addicted, in part because addiction itself is a political phenomenon whose definition varies in time and space). Beyond this, each of us is constrained by systems of language – what is “free thinking,” really, when the words we’ve been socialized into using aren’t even our own?