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More than 2.5 million US children use e-cigarettes - rising a half-million from last year and reversing downward trends in recent years
Several theories have been hypothesized regarding the mechanisms by which smoking lowers testosterone levels owing to Leydig cell dysfunction by various mechanisms such as chronic hypoxia, smoke-induced oxidative stress (ROS), neuroendocrinal effect of nicotine on hypothalamo-pituitary-gonadal axis, direct cytotoxic effect on Leydig cells either causing downregulation of key enzymes of steroidogenesis (NR5A1, CYP11A1, and 3b-HSD1) or by inducing apoptosis (by increase in Bax (proapoptotic protein) and caspase-3 expression, and a decrease in Bcl-2 (an antiapoptotic protein) expression[]
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There is no evidence to support claims that smokers switch from traditional cigarettes to exclusive use of heat-not-burn tobacco products
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