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In both cases, a strong inflammatory response was elicited, paired with increased oxidative stress and systemic cytokine release, which likely affected platelet function and general circulatory homeostasis.82 Platelet function seems to be modified by electronic cigarette vapours

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Research shows that people with these conditions account for nearly 40% of all cigarettes consumed in the U.S., despite representing a much smaller share of the population. Population-based studies, including a major Norwegian survey, have found that individuals with symptoms of anxiety and depression are significantly more likely to be current smokers compared to those without these symptoms. This association is particularly concerning because individuals with depression or anxiety often smoke more heavily and are more likely to become nicotine dependent. Additionally, the co-occurrence of both conditions has been found to strengthen the association with tobacco use, suggesting a compounding effect. The relationship between tobacco use and emotional distress is commonly explained by the self-medication hypothesis

J Allergy Clin Immunol

So it shifts energy away from testosterone and into stress mode