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The most frequently cited source of alcohol for current underage drinkers was an unrelated person aged 21 or older (28%), followed by family and friends

This damage leads to build of tar and other pollutants in your lungs which can cause discoloration and the blackening of lung tissue

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This is because CO displaces O 2 from hemoglobin forming carboxyhemoglobin (CO affinity for hemoglobin is 200 times that of O 2 ) and shifting the oxygen dissociation curve to the left, thereby causing hypoxia and impairment of cellular respiration [76]

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They are completely free to download and can be used along with Photoshop to create those amazing and awesome smoke effects as you saw above.