Smoking and erectile dysfunction
Reviewed by Dr Bhavini Shah
Erectile dysfunction (ED) is the inability to get and keep an erection long enough to have sex. ED has many causes, one being smoking. Smoking can cause erectile dysfunction in men of all ages, including young men. In this article we'll look at the link between smoking and ED, and other factors that might cause the condition.
How common is erectile dysfunction in men?
Erectile dysfunction is particularly common in men over the age of 40 but younger men can experience it too. It’s thought that as many as 50% of men aged 40 to 70 will have experienced ED at some point in their lives. And as many as 70% of men over 70 will have it. In younger men, it’s thought that between 20% and 40% of men under the age of 40 experience the condition.
ED can be caused by a variety of different factors like:
- Smoking
- High blood pressure
- Diabetes
- Drinking too much alcohol
But in that younger age bracket it’s thought that around 60% of cases will be down to psychological causes, such as:
- Anxiety
- Stress
- Depression
- Relationship issues
- Watching porn
Can smoking cause erectile dysfunction?
Smoking can make men twice as likely to have ED. Smoking can damage blood vessels in your body which can impair blood flow and circulation. This can make getting and keeping an erection difficult.
A 2005 study found that:
- Around 12% of men who’ve never smoked experienced ED
- Around 17% of men who have smoked at some point experienced ED
- Around 23% of men who smoked for over 29 ‘pack-years’ (number of years cumulatively they’ve smoked 20 cigarettes a day) experienced ED
But there is some evidence that quitting smoking using smoking cessation can reduce how often you experience erectile dysfunction and lower your risk of having the condition.
What can cause erectile dysfunction?
Other factors besides smoking can cause erectile dysfunction, these include:
- Medical conditions such as high blood pressure and diabetes
- Psychological disorders such as depression and anxiety
- Obesity
- Excessive alcohol consumption
- Use of recreational drugs and illegal drugs
If you are experiencing ED, you can talk to your GP. They will ask you questions about your symptoms and find out if there is an underlying medical cause for the ED.
Smoking and sexual health
The ingredients within cigarettes and vaping products are harmful to the body. They can even impact your sexual health.
Erectile dysfunction
Cigarettes release many thousands of chemicals when burnt. Over 250 of these chemicals are harmful.
Nicotine is likely to be the most important chemical linked to ED. It may interfere with the nitrous oxide (NO) pathway which is important for strong and healthy erections.
It also causes arteries to constrict and stiffen, thereby reducing the blood flow to the penis. Nicotine can also cause damage and/or inflammation of the artery walls, again reducing blood flow. A damaged blood vessel can encourage fatty deposits which will further narrow the blood vessels and stop blood flowing easily to the penis.
Does vaping cause erectile dysfunction?
Smokeless tobacco or vaping products also contain nicotine, so whilst they might have fewer harmful chemicals, the damaging effect of the nicotine is the same. Researchers at New York University found that using e-cigarettes doubled the risk of men aged 20 and over getting ED.
Ideally you should avoid all types of smoking, vaping, tobacco products and exposure to second-hand smoke to reduce your risk of erectile dysfunction.
How long after quitting smoking does erectile dysfunction improve?
How long it takes for you to see the change in your ED symptoms can vary. One study found that after a year, ED symptoms improved for 25% of the participants that were now ex-smokers.
The time it takes is based on the individual, age, the severity of your erectile dysfunction prior to quitting smoking, and other major health problems.
Help quitting smoking
It can take multiple attempts to quit smoking. You may choose to go cold turkey, but you have a greater chance of stopping by using stop smoking products such as nicotine replacement therapy (NRT) or prescription medications. These can eliminate withdrawal symptoms and reduce cravings.
Getting support through friends, changing your lifestyle and using your local NHS Stop Smoking Service can help too. You’re not alone, find out more about how to stop smoking and make today’s cigarette your last.
Treatment for erectile dysfunction
The most well-known treatment for ED is Viagra often called the little blue pill, but there are other medications available. These include:
- Sildenafil the active ingredient in Viagra and the generic version which can work in as little as 25 minutes
- Cialis the branded version of tadalafil which effects last for up to 36 hours
- Viagra Connect is available without a prescription
- Vitaros is a cream applied to the penis which works in 5-30 minutes
The right treatment for you will depend on your own needs and if you have any health conditions. If you’re not sure which is right for you, find out about the difference between Viagra and Sildenafil. Our clinicians can also help, simply complete an online consultation for personalised treatment recommendations.
Getting advice and help for erectile dysfunction
For some men, erectile dysfunction can be an awkward subject to talk about in general, whether that’s with a partner or a doctor. However, the sooner you acknowledge the issue and speak to someone, the sooner you’ll be able to find a solution or treatment best for you.
As well as this, erectile dysfunction can be a sign of other developing health issues, so it’s important that if you persistently struggle with getting and maintaining an erection that you go to your GP. They might suggest some tests to look for medical causes such as diabetes, high blood pressure, high cholesterol or hormone issues and discuss with you how to manage your erection difficulties best depending on the most likely cause.
You can also use our online ED consultation, and our clinicians will suggest the right treatment for you, if needed.
Conclusion
For some people smoking can lead to erectile dysfunction. If you’re a smoker and experiencing ED one of the ways you can improve your erections is to stop smoking. There are also ED treatments that can help. As well as seeking treatment, you should also speak to your GP as ED can often be a sign of an underlying health condition.
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291852/
https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485976/
https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/cessation-fact-sheet
https://academic.oup.com/aje/article/161/4/346/92680
https://patient.info/mens-health/erectile-dysfunction-impotence
https://patient.info/news-and-features/erectile-dysfunction-impotence-in-young-men
https://www.cancer.gov/publications/dictionaries/cancer-terms/def/pack-year
https://www.sciencedirect.com/science/article/abs/pii/S0022534705656418
https://pubmed.ncbi.nlm.nih.gov/15610111/
https://www.ajpmonline.org/article/S0749-3797(21)00429-3/abstract
