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Smoking can cause deficiencies in several other nutrients than zinc, like vitamins A, E, C and cause significant oxidative stress from harmful free radicals

In studies among Indian men, heavy smokers or frequent tobacco chewers consistently displayed the worst semen and hormone profiles, underscoring how deeply tobacco can undermine male reproductive health

By contrast, in the US, a recent study among adults with SUD receiving treatment, suggested a decreasing prevalence between 2006 (46.5%) and 2019 (35.8%) 11 , somewhat lower than prevalence measured in a prior study: in 2014, current smoking prevalence was 64.3% among patients with AUD and 55.0% among SUD 12