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This is probably caused by a tumor that has formed in the body or tail of the pancreas because it can press on the spine, according to Johns Hopkins Medicine

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Tobacco smoking is considered one of the major factors leading to male infertility

The MassHealth Tobacco Cessation Benefit provides resources that facilitate smoking cessation

Because of how energy efficient homes are these days, sealed homes with added insulation, super weather-tight windows, and other types of things made to increase the heating and cooling factors of ones home, can actually have a reverse, more detrimental effect in regard to inadvertently increasing the levels of carbon monoxide in the home, as our homes get closed up more than ever before, and hence not allowing any rising carbon monoxide to more easily escape to the outside