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The second game makes it canon that this is because killing feels like sex to him

Paskett ED, Reeves KW, Rohan TE, Allison MA, Williams CD, Messina CR, et al

Dangers of Underage Tobacco Use 5 Short-term Effects Some of the short-term effects of smoking include: Addiction to nicotine and exposure to dangerous chemicals More breathing problems Shortness of breath, phlegm, and a coarse cough Impaired lung growth and function Bad breath , yellow teeth, and stained fingers Foul-smelling clothes and hair 6 Long-term Risks Additional long-term risks of smoking include: Addiction to nicotine and exposure to dangerous chemicals Lung, mouth, throat, kidney, and stomach cancers Heart disease Impaired immune systems Emphysema and other chronic diseases Shorter lifespan (up to 20 years shorter) 7 Other Risks from Smokeless Tobacco Use Health risks of smokeless tobacco use include: Oral cancer and gum recession Gum disease Tooth decay Nicotine addiction Increased likelihood of becoming a smoker