How Smoking Increases the Risk for Erectile Dysfunction (ED)

Last Updated Sep 1, 2024

Some studies have found that lifestyle factors like smoking and alcohol may also increase men's risk of ED. But how exactly does smoking cause erectile dysfunction, and is the risk significantly higher for smokers compared to non-smokers?

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Image of a man smoking a cigarette

Key takeaways:

  • Erectile dysfunction (ED) is the constant inability to achieve or maintain an erection during sex.
  • Men who smoke have higher chances of developing ED.
  • Quitting smoking may help reverse the symptoms of ED in the absence of other underlying health conditions.

Erectile dysfunction (ED), also known as impotence, is a sexual disorder that arises as a result of the constant inability to get or keep an erection during sexual intercourse. 

This sexual disorder can occur at any age, although it is more common in older men. According to the Journal of Sexual Medicine, erectile dysfunction affects as much as 26% of men under the age of 40. 

Occasional erection problems are normal, but persistent difficulty achieving or maintaining an erection can indicate underlying health issues. If you constantly struggle to maintain an erection, it is best to consult with a healthcare professional.

Can smoking cause erectile dysfunction?

Smoking can significantly increase the risk of ED. Studies have shown that smokers are more likely to experience ED compared to non-smokers.

Smoking contributes to ED by reducing blood flow to the penis, making it difficult to achieve and maintain an erection.

It's important to note that while smoking is a risk factor, other factors such as age, overall health, and psychological conditions can also contribute to ED.

How smoking causes erectile dysfunction

For a penis to achieve an erection, it needs a compound called nitric oxide (NO) to relax its tissues. This relaxation allows blood to flow in, creating a firm erection.

Smoking significantly reduces the body’s nitric oxide levels, hindering the relaxation process necessary for an erection. NO is destroyed because smoking damages the nerves and the inner lining of blood vessels.

In addition, some studies have found that smoking can lower testosterone levels, leading to decreased libido and erectile function.

Studies have found that cigarettes contain harmful substances like nicotine, carbon monoxide, oxidants, and heavy metals. These toxins can damage the lining of blood vessels (endothelium), disrupting the erectile process and leading to erectile dysfunction (ED).

One study involving over 2300 men revealed that current smokers are more likely to experience ED compared to both former and non-smokers. This risk tends to increase with age.

Another study demonstrated a 51% increased risk of ED for current smokers and a 20% increased risk for former smokers compared to people who have never smoked. This equates to a more than twofold higher risk of ED among smokers.

Other factors that can cause ED

The other factors that can cause Erectile Dysfunction include

Signs and symptoms of ED

Here are some signs and symptoms that may indicate erectile dysfunction in men:

  • Difficulty in achieving  erection
  • difficulty maintaining an erection
  • Reduced libido
  • Fewer spontaneous erections

It's important to note that experiencing these symptoms doesn't necessarily mean you have ED. Other factors, such as stress, anxiety, fatigue, or low testosterone levels, can also contribute to these symptoms.

Treatment for erectile dysfunction (ED)

The treatment options for erectile dysfunction (ED) include: 

  • Lifestyle changes: This involves quitting smoking and alcohol consumption, maintaining a healthy weight, and engaging in exercise activities. 
  • Medications: Your doctor can recommend some medications to help treat the ED. 
  • Vacuum Erection Devices (VEDs): These devices helps create a vacuum and draws blood to the penis. 
  • Surgery: Surgery can be considered when every other option has failed. There are penile implants and vascular surgeries done to repair or replace damaged blood vessels in the penis. 

Will quitting smoking improve erectile dysfunction?

Quitting smoking may help reduce the risk of erectile dysfunction, as reported in the Journal of Urology. However, these improvements are more likely to be seen in younger men or those without any underlying health conditions.

Here are some ways quitting smoking can help improve erectile dysfunction and overall sexual function: 

Improved blood flow:

As you quit smoking and your body gradually heals, blood flow to the penis can improve, which may lead to restored erectile function. 

However, the timeline for improvement varies from person to person, and other factors, such as overall health and the severity of ED, can also influence the outcome.   

Improved health:

Quitting smoking can reverse other health conditions linked to smoking, such as heart disease, diabetes, and high blood pressure, which are common contributors to erectile dysfunction.

How to quit smoking

Quitting smoking is a great decision for your health, and it can be tough, but it is achievable if you set your mind to it. Here are some tips to help you quit:

1. Prepare yourself

You can prepare yourself to quit smoking by picking a date and sticking to it. You may also write down all the reasons why you want to quit smoking in a diary for documentation and easy reminders. This will help you stay motivated when the cravings hit.

2. Manage your cravings

When cravings come, keep yourself busy with activities you enjoy, like taking a walk, listening to music, or calling a friend. 

If you are yet to adopt a healthy coping mechanism, try to recognize situations that make you crave cigarettes and plan how to avoid them. 

You may also consider using Nicotine Replacement Therapy patches, gum, lozenges, or inhalers to manage withdrawal symptoms. But consult your doctor first to see if Nicotine Replacement Therapy is right for you.

3. Seek support

Seek support from friends and family to help in your journey. You may also seek medical support by contacting your doctor for medical advice, medication to manage cravings, and help developing a personalized quit plan.

Other health conditions linked to smoking

Smoking is harmful to all the organs in the body and can cause a variety of other health problems. Some of the other health conditions linked to smoking include:

Respiratory diseases

Smoking is the leading cause of chronic obstructive pulmonary disease (COPD), a group of lung diseases that includes emphysema and chronic bronchitis. According to the CDC, 8 out of 10 of all deaths from COPD are caused by smoking.

Heart disease

The heart is one of the major organs affected by smoking. Long-term smoking increases the risk of developing cardiovascular diseases such as coronary heart disease ( Damage to the arteries that supply oxygen to the heart), stroke ( a clot blocks the blood flow to part of the brain), and peripheral artery disease (PAD). PAD causes narrowing of the arteries in the legs and feet.

Diabetes

The more you smoke, the higher your risk of developing type 2 diabetes increases. Smoking increases this risk by 30–40%.  It can also make it harder to control your blood sugar if you already have diabetes.

Cancer

Tobacco smoke contains over 4,000 chemicals, and 70 out of them are known to cause cancer.

Smoking is a risk factor for lung cancer, as well as cancers of the mouth, throat, esophagus, bladder, kidney, pancreas, stomach, liver, cervix, and leukemia.

Immune system problems

The immune system is weakened by smoking, making it easy to get infected by bacteria or viruses.

Arthritis

The risk of developing rheumatoid arthritis, a chronic inflammatory disease that causes pain, swelling, and stiffness in the joints, is increased when you smoke.

Vision problems

Your chances of developing eye-related problems are two times higher when you smoke than in non-smokers. Smoking increases your risk of developing age-related macular degeneration, a leading cause of vision loss in older adults.

Pregnancy complications

Smoking in pregnancy poses a serious health risk for the fetus. A study by the University of Cambridge reported that smoking during pregnancy increased the risk of miscarriage, premature birth, and low birth weight by 2.6 times. It can also increase your baby's risk of sudden infant death syndrome (SIDS).

When to see a doctor about ED concerns

If you experience erectile dysfunction (ED) multiple times, it's important to consult a healthcare professional for diagnosis and treatment options. Early intervention can significantly improve sexual function and overall health.

Also, lifestyle changes like quitting smoking may improve blood flow, reduce inflammation, and promote overall well-being, indirectly improving erectile dysfunction.

Frequently Asked Questions (FAQs)

How much smoking can cause ED?

There is no standard way of measuring how much smoking can cause ED. However, several factors can influence the severity of the ED. These include the duration of smoking and the quantity consumed over time.

Will quitting smoking increase testosterone?

The evidence for a direct testosterone increase from quitting smoking is inconclusive. This is because the exact relationship between nicotine and testosterone remains unclear. Some studies suggest that nicotine raises testosterone levels, while others indicate it lowers them.

References

  1. The Journal of Sexual Medicine. (2013) Prevalence of Erectile Dysfunction
  2. Kovac J.R. et al. (2015). Effects of cigarette smoking on erectile dysfunction
  3. Rita. C et al. (2008). Cigarette smoking and erectile dysfunction: focus on NO bioavailability and ROS generation
  4. Paolo V.  et al. (2015) The Link Between Cigarette Smoking and Erectile Dysfunction: A Systematic Review
  5. The Centers for Disease Control and Prevention (2023) smoking and diabetes
  6. Kupelian V. et al. (2007). Association between Smoking, Passive Smoking, and Erectile Dysfunction: Results from the Boston Area Community Health (BACH) Survey
  7. Shiri R. et al. (2013) Smoking and Risk of Erectile Dysfunction: Systematic Review of Observational Studies with Meta-Analysis
  8. International Braz J. Urol. (2020) Effect of smoking cessation on sexual functions in men aged 30 to 60 years
  9. Centers for Disease Control and Prevention. (2024)  How to Quit Smoking
  10. Centers for Disease Control and Prevention (2014) Health Effects of Cigarette Smoking Data
  11. Centers for Disease Control and Prevention. (2023) Smoking and Diabetes 
  12. Centers for Disease control and prevention. (2023). Vision Loss and Blindness
  13. Roshan Daily (2023). Objective measures of smoking and caffeine intake and the risk of adverse pregnancy outcomes. Food and Drug Administration. Gov (2014) Let’s Make the Next Generation Tobacco-Free: Your Guide to the 50th Anniversary Surgeon General’s Report on Smoking and Health (Consumer Booklet).
  14. Testosterone Centers of Texas. (2022).  Does Smoking Decrease Testosterone?