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Also, meeting with a male fertility specialist can help educate patients on the potential risks and provide personalized advice. He also emphasizes the importance of supporting overall health with a balanced diet, regular exercise, and effective stress management to improve fertility

The first generations of ENDS contained primarily freebase (unprotonated) nicotine, known to be alkaline, resulting in greater harshness and a less desirable experience upon inhalation [26]

The trends observed in our study align with those seen in countries such as Japan and China, where similar increases in all-cause and lung cancer mortality among smokers have been reported 22,27

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While cigarillos and cigarettes differ in how they are made and smoked, both carry significant health risks and neither should be viewed as a safer alternative to the other