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.
Over the years, numerous studios formed, which specialize in producing adult material aimed mainly at smoking fetishists.
Some of the studios also offer custom-made productions catering to sub-fetishes, such as a smoking female extinguishing a cigarette on the leather seats of a luxury car.