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As a fetish, its mechanisms regard sexual arousal from the observation or imagination of a person smoking , sometimes including oneself. Capnolagnia is not considered a disease but an unusual sexual practice, and many of the fetishists do not seek medical help unless this behavior strongly interferes with their daily lives. The majority of people simply learn to accept their fetish and manage to achieve gratification in an appropriate manner. A study found that the fetish was not previously the subject of academic study but had been mentioned in "a few newspapers". Like any fetish, the causes and mechanisms of a smoking fetish vary widely, with roots of sexual association in early childhood and adolescence.

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