Buerger's disease (a.k.a thromboangiitis obliterans) is a relatively rare, persistent, recurrent disease which predominantly affects tobacco users. It was first documented in the late 1800s.

It leads to severe inflammation of the small and medium arteries, veins, and nerves of the extremities of the arms and legs - usually starting in the age range 40 - 45.

In extreme cases it can require amputation of the affected limbs.

Although it's now certain that it's strongly linked to tobacco use, the exact underlying mechanism remains unknown.

Although the cause of Buerger's disease remains unknown, a strong association with tobacco use has been established. Use or exposure to tobacco plays central role in the initiation and progression of the disease.
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Most investigators feel that Buerger's disease is an immune-mediated endarteritis.

Source :Orphanet Journal of Rare Diseases, volume 1, Article number 14.