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Risk of erectile dysfunction can increase as more tobacco cigarettes are smoked and nicotine levels therefore rise, which also held true in the study for e-cigarettes, El Shahawy said

Smoking decreases the level of efficacy of testosterone by increasing the level of testosterone-binding proteins in the body, with a faster rate of deactivation of testosterone in the liver

Current and former smoking were combined for the reference category to avoid multicollinearity with the childhood smoking variable in multivariable analysis