It is really hard to acknowledge, even when seriously ill.
Yeah, having the hands do something familiar like that might help, that was never my issue; my issue was I enjoyed it. But I think there is way more involved with me than the ciggies, since I worked on the roads I did a lot with asphalt grinders and tree work with chain saws and wood chippers, and have inhaled a lot of the dust which is physical and cannot be absorbed through the lung linings, so it never dissipates. I never thought about it nor worried about it at the time. All of the herbicide spraying we did was chemical, and can pass through the system, but the solids cannot, so I'm stuck with them.
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yeah all of those will have had their impact. For me it was the dust in the pharmaceutical firm where I worked. It all builds up.