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About 440,000 people each year in the U.S

Heavy smoking is usually defined as smoking 20 or more cigarettes per day (about 1 pack or more daily)

Historical data indicates that smoking rates have fluctuated, but the negative effects on fertility remain consistent

Study selection We included studies irrespective of sample size

Among tobacco users, those who consumed e-cigarettes exhibited the highest prevalence of a smell disorder at 16.4% (95% CI: 12.220.7) and the second-highest prevalence of a taste disorder at 11.0% (95% CI: 7.514.6), surpassed only by poly-tobacco product users with16.0% (95% CI: 15.117.1) for smell disorder, and 11.4% (95% CI: 10.512.2) for taste disorder