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48 A 2022 survey found that more than 60% of physicians believed all tobacco products to be equally harmful, 49 a lamentable failure of medical and public health education and leadership

Ways that smoking affects male infertility Reduced Sperm Concentration and Count The alkaloids nicotine and cotinine, the main pharmacologically harmful agents of tobacco, can cross the bloodtestis barrier from where they may impair spermatogenesis, leading to reduced sperm concentration and total count, as well as decreased motility

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