Tobacco use has been heavily associated with Cluster C personality disorders, of which OCPD is a part of. Compulsive exercise, a behavior present in some with OCPD, can lead to an increased risk of injury. More broadly, OCPD personality traits may negatively impact health through psychosocial stress overactivating the autonomic nervous system, hypothalamic–pituitary–adrenal (HPA) axis, metabolic systems, and the immune system, leading to numerous poor health outcomes.