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This indicates that smoking may influence certain aspects of female reproductive health, even in the absence of significant changes to testosterone levels

Less serious side effects include severe acne and changes in sex characteristics, like shrinking of the testicles in men and growth of facial hair in women

Briefly, the studies that were extracted represented several types of study design (for example, cohort and casecontrol studies), measured exposure in several different ways and varied in their choice of reference categories (where some compared current smokers with never smokers, whereas others compared current smokers with nonsmokers or former smokers)

This proposal is now under legislative review by the Bundestag and could take effect in mid-2025 or 2026