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Because of the social nature of hookah, secondhand smoke is also a risk factor

Some studies have found higher testosterone levels in smokers, but the evidence is mixed, and smoking poses significant health risks that outweigh any potential hormonal effects. Does smoking affect male fertility

Increased risk of chronic obstructive pulmonary disease (COPD) This study found that marijuana smoke is associated with increased risk of COPD, and the risk is greatest among people who combine marijuana smoking with cigarette smoking

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