I’ve actually seen studies where pipe smokers even lived longer than non-smokers!
My best friend is a very talented therapist. He found the study quite interesting, and said it may be a whole host of factors, but that in general he could see how pipe smoking is a great stress reliever. And he suggested that the benefits provided there certainly could outweigh any negative impacts of smoking. (Of course pipe smoking is the safest form of smoking, followed by cigars, as the smoke is not inhaled and the nicotine is absorbed via the mucus membrane in the mouth and nose.)
He also said that almost ALL of his adolescent patients who wrestle with things like ADD/ADHD smoke cigarettes (or vape these days.) He attributes that to being a sort of natural phenomenon, bc those patients are usually treated with stimulants, and nicotine is a stimulant. Thus, it provides them a certain mental clarity they likely don’t even directly realize or correlate to tobacco use. And so, along with the other obvious addictive elements present, they are also naturally drawn to nicotine consumption for its therapeutic properties.