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Over time, smokings impact on testosterone levels and increase risk of conditions such as high blood pressure and heart disease, all contribute to the increased risk of erectile dysfunction

Second, if multiple risk estimates with different adjustment levels were reported in a given study, we included only the fully adjusted risk estimate and modeled the adjustment level according to the number of covariates adjusted for (rather than which covariates were adjusted for) and whether a standard adjustment for age and sex had been applied

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