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It was elitism, sure

Tonsil stones, medically known as tonsilloliths, are hard, small formations that develop in the crevices of the palatine tonsils

Is Nicotine Polacrilex Gum just substituting one form of nicotine for another

Clindamycin has demonstrated efficacy in reducing inflammatory lesions, with clinical trials showing it to be superior to placebo and comparable in efficacy to oral tetracyclines [44]

In adult tobacco smokers, electronic cigarettes have been shown to be beneficial as cessation aids, but ultimately, the scientific evidence has indicated limited efficacy to reduce tobacco use over the long-term (914)