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A 2024 study also found a positive association between serum cotinine levels (a biomarker for nicotine exposure) and total endogenous testosterone levels

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10.1016/S0140-6736(20)30752-2 33 GerschM.GladkovaC.SchubertA

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At the week 12 visit the corresponding proportions were 19.6% in the snus group (31/158) versus 12.4% in the placebo group (20/161) for an estimated odds ratio of 1.7 (95% C.I.: 0.94-3.23, p = 0.08)