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Smoking damages the genetic material in sperms, and it cause chromosome damage and DNA fragmentation in sperm Marijuana use affects men by decreasing the sperm count and the quality of the sperm Alcohol interferes with the synthesis of testosterone and has an impact on sperm concentration, it also delay a mans sexual response and may cause impotence, the inability to have or sustain an erection

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Although nicotine has a substantial impact on alterations in heart frequency, blood stress, and cardiac output caused by smoking, its involvement in atherothrombotic illness related to CS is still debated (56)

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