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Furthermore, high rates of dual use may result in greater total public health burden and possibly increased individual risk if a smoker maintains an even low-level tobacco cigarette addiction for many years instead of quitting. The authors are Rachel Grana, PhD, MPH, a postdoctoral fellow at the UCSF Center for Tobacco Control Research and Education (CTCRE)

Additionally, nicotine from smoking may stimulate the production of cortisol, a stress hormone, which can suppress testosterone levels in men