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20 In a 2025 social network-based intervention for adolescent smoking the results found that targeting students who are well-connected and influential led to the greatest long-term reductions in smoking

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As a result, young people may have reduced inhibitions, greater risk-taking behaviors, problems in school and mental health struggles, including anxiety and depression

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One work published in the mid '50s, described it as "at best, an ungentlemanly and dirty habit," while for 1860 warns gentlemen that Cassell's Hand-book of Etiquette If you smoke or take snuff, you will find it difficult to observe that constant personal cleanliness so essential in a gentleman