One of these people have to die. Who do you choose?

Works for me. This isn’t quite the dilemma the OP thought, now is it?

I invite the smoker to step outside and light up, offering to meet him outside in a moment. When Smoker gets outside I give Gramps and Timmy a pill, one to each. I announce, “Now, gramps you’ve got the next six months to give Timmy the best parts of your best wisdom that you’ve gained throughout your lifetime. And, Timmy, PAY ATTENTION!!!”

I tell Timmy to pay attention to gramps for the next six months and, after that, he will have three months to use whatever he learned to make the world a better place."

Then I tell them, “While I’m out enjoying a cigarette with Smoker, you two need to decide which of us should be given a pet goldfish.” And then I go outside and stand around chatting with Smoker.

Does EG provide a deadline for the answer? I stand outside with Smoker for D-minus-three-minutes. At D-minus-five-minutes I tell Smoker that the guys inside are going to award a goldfish to one of us and whoever gets the goldfish has to take a pill. Then we go inside and receive the decision. The goldfish, of course, is a proxy; it doesn’t really exist. Refuse the goldfish = refuse the pill.

If Gramps and Timmy haven’t agreed (or otherwise have not chosen one of us) when we go back inside, I challenge Smoker to a sparring match. Admittedly, that’s a bit unfair in many ways, but his lessor age off-sets his lessor lung (etc) health and since I (apparently) don’t know him there’s no reason to automatically believe he’s less skilled than me. The loser of the match doesn’t get the goldfish (or the pill) – but that might be a moot point when the dust settles.

----G!
Well I look at the end
Why understand it?
I’ve got livin’ to do
…–Steve Augeri (Journey)
Livin’ to Do
…Arrival

ETA: Oh! I guess if I die they wont know where to find the goldfish to give to the winner.

Wait, can I change my answer to the goldfish one? I don’t entirely follow it, but I’m hoping for a contact high.

Second hand smoke kills. Snuff the smoker and possibly save one or more other lives that his habit might have taken. All other lifestyles being equal, (because they are unknown and outside the hypothetical) this is the option that might result in a net gain in lives.