what effect does chewing tobacco have on the body doesn't damage your health overnight. It starts quietly. A pouch here. A chew there. A habit that feels harmless. But long before symptoms appear, tobacco can begin affecting your mouth, heart Tobacco/Nicotine - Rutgers Addiction Research

All this is to assume that Doyle the physician/author was the alter ego of Holmes the detective

Many studies provide results for smoking of any product (162 studies, 60.7%) or for cigarettes (147, 55.1%), but less do so for cigarette only smoking (55, 20.6%), smoking of pipes/cigars only (62, 23.2%), mixed smoking (29, 10.9%), or for the cigarette type indices filter/plain cigarette smoking (38, 14.2%), hand-rolled cigarette smoking (15, 5.6%), or mentholated cigarette smoking (3, 1.1%)

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They said, 'Do they have to smoke?'" Jon remembered

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