the contents of a cigarette is mashed in a cup with about a half a teaspoon of water to make a paste that is then applied to the affected area. Impact Social Smoking in public was, for a long time, reserved for men, and when done by women was sometimes associated with promiscuity; in Japan, during the Edo period, prostitutes and their clients often approached one another under the guise of offering a smoke. The same was true in 19th-century Europe. Following the American Civil War, the use of tobacco, primarily in cigars, became associated with masculinity and power. Today, tobacco use is often stigmatized; this has spawned quitting associations and antismoking campaigns. Bhutan is the only country in the world where tobacco sales are illegal. Due to its propensity for causing detumescence and erectile dysfunction, some studies have described tobacco as an anaphrodisiacal substance. Religion Christianity In Christian denominations of the conservative holiness movement, such as the Allegheny Wesleyan Methodist Connection and Evangelical Wesleyan Church, the use of tobacco and other drugs is prohibited; ¶42 of the 2014 Book of Discipline of the Allegheny Wesleyan Methodist Connection states: Members of the Church of Jesus Christ of Latter-day Saints (popularly known as Mormons) adhere to the Word of Wisdom, a religious health code that is interpreted as prohibiting the consumption of tobacco as well as alcohol, coffee, and tea. Islam Most Islamic scholars have condemned tobacco due to its harmful effects on health. The earliest fatwa (religious opinion) against tobacco use dates from 1602, and today, most major Islamic sects prohibit muslims from using it. While tobacco is not mentioned in the Quran, the Quran does instruct muslims to live healthy lives. Sikhism Sikhism, a monotheistic religion from India, considers tobacco consumption as a taboo and very bad for health and spirituality. Initiated Sikhs are never to consume tobacco in any form. Demographic Research on tobacco use is limited mainly to smoking, which has been studied more extensively than any other form of consumption. An estimated 1.1 billion people, and up to one-third of the adult population, use tobacco in some form. Smoking is more prevalent among men (however, the gender gap declines with age), the poor, and in transitional or developing countries. A study published in Morbidity and Mortality Weekly Report found that in 2019 approximately one in four youths (23.0%) in the U.S. had used a tobacco product