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For instance, male heavy smokers have been found to have a 20% to 40% reduction in serum ascorbic acid levels, but when they are given as supplements the sperm quality has been shown to improve [111, 112]

Prof Fairley says more studies are needed to check how long this effect might last and what protection it might offer

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In addition, GBD 2019 data only considered smoking grass products, and therefore, some tobacco-free products, chewing tobacco, and tobacco plants were not included, which may also have led to some discrepancies between the study results and the true situation