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Infertility : Infertility, particularly in women, where nicotine affects hormone levels, disrupts ovulation, and diminishes fertility

This could be because men are more likely to be smokers and are more likely to have suffered workplace chemical exposure

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161 Therefore, it is difficult to determine whether traditional smoking has different effects on the oral cavity than ECs or heat-not-burn products, making further research in this area necessary (Tables S2, S4S7, available on request from the corresponding author)