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Genetics: People of African ancestry have a genotype that may cause them to metabolize cotinine more slowly than people of other ancestries
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Smoking weakens sperm, which can impact these measurements and reduce sperm quality
[13] As of 2008 to 2010, tobacco is used by about 49% of men and 11% of women aged 15 or older in fourteen low-income and middle-income countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam), with about 80% of this usage in the form of smoking
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