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DISCUSSION The primary purpose of this cross-sectional study on 488 subjects was to determine whether there is an association between tobacco smoking and cutaneous photoaging, AKs, cancers, or nevi in subjects considered to have an elevated risk for any type of skin cancer

Ollie Ganz et al., Regional Variations and Market Share of FDA-Authorised Products for Top-Selling Electronic Cigarette Brands in the USA: 20222024, Tobacco Control , April 22, 2025, Emma Rumney et al., How Middlemen Funnel Illegal Chinese Vapes into the United States, Reuters, June 23, 2025, Mark R

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Another layer here is that smoking affects testosterone levels indirectly by stressing out your adrenal glands, which are responsible for managing your bodys hormone response