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Substance use disorder negatively affects sexual function by reducing the production of the male hormone testosterone and female hormone estradiol, leading to reduced sexual desire, infertility, and erectile dysfunction, according to a 2019 study on sexual dysfunction in persons with substance use disorders published in the Journal of Psychosexual Health

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While the brand highlights its natural tobacco and additive-free blends, it clearly states that its products are not safer than other cigarettes

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