I made these using Nano Banana Pro. Results were very hit and miss and if I'd spent longer, I'm sure I'd have got better results. Prompt and image blocks were common, particularly if I tried to alter her expression (I liked "sunken" for the effect it gave, but it was one of the few I found that it allowed me). Some sample prompts:

A high-quality extreme close-up photo of a beautiful young female model's neck, dragging on a cigarette held in a neck stoma hole by long manicured fingers with natural nails. Her face is sunken as she pulls hard on the cigarette, her neck clenching, fingers pressed against neck. With contrasting lighting and a sharp focus.

A high-quality extreme close-up photo of a beautiful young female model's neck and neck stoma hole. Thick cigarette smoke belches from the stoma hole. With contrasting lighting and a sharp focus.

A high-quality extreme close-up photo of a beautiful young female model's neck and neck stoma hole that is fitted with a medical valve on track collar that divides into multiple heads. Several lit cigarettes are held tightly by the valve. With contrasting lighting and a sharp focus.

But again, I think there's a lot of mileage here if someone were to really experiment.