Smoking and Erectile Dysfunction

13.12.2021 - Ori Gidor

Smoking has always been a symbol of enhanced masculinity. But while most male smokers are very much aware, that this habit increases their risk for lung and cardiovascular disease, many men are still unaware of the smoking-associated risk that hits “below the belt.”

If atherosclerosis, heart disease and certain cancers haven’t been a good enough reason for men to quit smoking, you’d better think it over: this habit increases significantly the risk for erectile dysfunction (ED) – a condition which manifests in a continuous difficulty attaining or maintaining an erection rigid enough for penetration during sexual intercourse. In Israel, 50% of the men aged 50 and over, and approximately 70-95% of the men aged 70 and over, suffer from ED, and every year about 70 thousand men are newly diagnosed with this problem.

Adequate sexual performance involves the coordination between several functions in the body, including in the nervous system, the endocrine and the cardiovascular systems. However, smoking can harm each of these systems and consequently cause ED.

Why does it happen? mainly (though not exclusively) because of nicotine – that highly stimulating substance naturally found in tobacco, which is associated with the pleasurable, euphoric feeling, which also makes smoking so incredibly addictive. But in addition to numerous respiratory, cardiovascular and possibly even neurological problems nicotine might cause, recent research studies have proved that it might also cause ED.


The Scientific Proof for the Warning on the Pack

Many recent studies point to a direct relationship between smoking and ED, as they found that the severity of ED in smokers, was closely linked to their level of exposure to cigarettes, cigars or pipes’ smoke. As an example, a study of more than 8,000 Australian men between the ages of 16 and 59, found that almost one in every 10 smoking men experience continuous erectile problems.

Those who used to smoke slightly less than a pack a day, had a 24% increased risk of erectile problems, and for those who averaged more than 20 cigarettes a day, the risk of ED increased by 39%.  And what’s more, the risk kept increasing in correlation with the number of cigarettes smoked daily. Based on the study results, the research team estimated that almost one quarter of all ED cases are caused by smoking.

While ED tends to be more common as men get older, it might develop at any adult age, as of puberty. A study from 2005 found that smokers were significantly more likely to experience ED, than men who had never smoked before. And when it comes to younger men with ED, smoking is definitely a very common cause. Therefore, if you are a younger man as well as a heavy smoker, research suggests that your chances of developing ED are much higher compared to men your age who don’t smoke.

For example, men smokers in their 40’s had the greatest risk – almost 3 time more, of developing erectile difficulties, compared to nonsmokers in their 50’s. Quite obviously, the level of risk correlated with the degree of smoking.

However, the good news is that despite the high risk, quitting smoking can definitely lead to symptoms’ improvement – it all depends on your age, the severity of ED before quitting smoking and whether you have any underlying health problems associated with smoking. I

n recent years, studies have established that long-term smoking causes more physiological damage. In an American study, for instance, healthy men aged 40-70 who smoked, but had no history of impotence, heart disease or diabetes, were interviewed twice over a period of 8 years.

In the second interview, it was revealed, that although these men had not (yet) developed heart disease or diabetes, they were twice as likely to experience moderate or severe ED. This means that sometimes ED can be the sole clinical sign of cardiovascular disease and coronary atherosclerosis (i.e. the heart’s arteries), even if there are no other patent clinical symptoms associated with it. Another study grouped smokers with ED according to how many cigarettes they smoked each day. The study concluded that heavy smokers (40+ cigarettes/day) had the “softest” night-time erections, and smoking was likewise related to an abnormal decline of blood pressure in the penis.


Passive Smokers? You Are Risk of Developing ED

Whether or not you smoke, if you are a middle-age man who likes to hang out in fume-filled bars, exposed to heavy vicarious smoke, you stand  twice the risk of developing ED as those who breathe clean air. These findings are based on a study which followed 513 men between the ages of 40 to 70, for a period of 10 years. It was found that 26% of the nonsmokers who were exposed to secondhand smoke, whether at home or at work, suffered from moderate or severe ED.

In contrast, only 14% of the nonsmokers who were not exposed to secondhand smoke reported ED. But the highest percentage of ED was among the men who were exposed to passive smoking both at home and at work – as a 1/3 of the men in this group had reported moderate or severe ED. However, the study has revealed yet another surprising fact: while among cigarette smokers, the rate of impotence was 24%, the group of cigar smokers had a 30% ED rate. So even if it seems that you don’t inhale cigars’ smoke at all, you certainly inhale enough nicotine and smoke for ED to develop.


How Does Smoking Cause ED?

As a general rule, problems in blood vessels constitute the most common cause of ED in men over 40, because of a reduction in penile blood flow due to narrowed arteries. The main risk factors are the development of atherosclerosis (where arteries become clogged with fatty substances called plaques), elevated levels of plasma lipids, obesity, and of course – smoking.

Tobacco products contain around 4.000 chemicals, of which at least 60 are known as toxic. Many studies have associated smoking with atherosclerosis, hypertension, cardiovascular disease and sudden death. Although the exact mechanism for the development of ED due to smoking has not yet been fully elucidated, it was in fact established that nicotine in tobacco constricts blood vessels in the body, causing poor blood supply to the penis. This makes getting and maintaining an erection very difficult.

Just think about it – the increase in blood flow required for an erection is comparable to that required by the heart for vigorous exercise – a fact which makes the association between ED and long-term smoking rather obvious. In addition to that, there is also a neural mechanism which contributes to smooth muscle relaxation during sexual arousal, in order to increase blood flow to the penis. As a result, a significant amount of blood is “trapped” in the organ, resulting in an erection.

This happens when touch or thought-induced sexual stimulation passes through like an electrical signal from the brain onto nerve sets along the spinal cord into the penis. That triggers the release of a molecule named Nitric Oxide (NO), which causes blood vessels to expand. However, recent research shows that the production of NO is decreased after exposure to cigarette smoke (due to the toxic compounds and free radicals it contains), resulting in the decline of smooth muscle activity required for adequate erection.

Interestingly, evidence from very recent studies likewise suggests that smoking might negatively impact on libido (probably through its effect on testosterone) and on sperm health. Thus, the negative effects of smoking on male sexual health seem to be very broad, as they include fertility challenges as well.


Before Taking Medications – Simply Quit Smoking

Despite the bleak reality male smokers seem to face, research suggests there’s good news. A pilot study which studied 65 men with ED, have shown that those who gave up smoking completely reported having full and firm erections again.  And what’s more, the men got sexually aroused more rapidly than before (without experiencing premature ejaculation) – 5 times more than former smokers who resumed smoking.

Other studies have shown that in certain circumstances, ED was dramatically improved within 6 months of quitting smoking, while men who have reported losing their erections prior to ejaculation, have completely reversed this situation by quitting smoking. Therefore, if you wish to improve your symptoms of erectile dysfunction naturally, simply try incorporating lifestyle changes: lose weight, maintain a healthy diet, exercise to improve blood circulation, and of course – quit smoking.

Smoking and Erectile Dysfunction


The Company hereby clarifies that the information contained on the website is for informational purposes only, and is not intended to be a substitute for professional medical and healthcare advice, and does not constitute medical advice or opinion. Always seek the advice of your physician or other qualified health provider with any medical condition or question you may have regarding a medical condition.

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