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In this retrospective cohort study, we analyzed the association between smoking and the occurrence of HUA by retrospectively analyzing cases of patients who were not diagnosed with HUA at baseline during at least 2 hospitalizations in Dalian Municipal Central Hospital between 1 January 2010 and 1 January 2021, and grouped them according to different smoking status and smoking index at baseline, to clarify whether smoking was an independent influencing factor for the occurrence of HUA

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Meanwhile, nicotine toxicity may be mediated through changes in collagen fibers that will prevent proper sperm release from germinal epithelium into middle cavity of spermicidal tubes [37, 38]

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