Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Research
  • Published:

Relationship between smoking and erectile dysfunction

Abstract

We estimated the effects of smoking on the risk and prognosis of erectile dysfunction (ED), and of ED on smoking behavior. The follow-up sample consisted of the 1442 men aged 50–75 y, who responded to both baseline and follow-up questionnaires. We estimated the effect of smoking on the incidence of ED among the 1130 men free from ED, ED on risk to start smoking in the 502 nonsmokers, smoking on the prognosis of ED among the 312 with ED and ED on quitting smoking among the 292 current smokers at baseline. Risk of ED increased nonsignificantly with smoking (odds ratio (OR)=1.4), while ED recovery reduced (OR=0.6). Therefore, there was the ratio of 2.3 (1.4/0.6) describing the total effect of smoking on the risk of ED. Both quitting (OR=1.7) and starting (OR=1.9) smoking were rare and nonsignificantly higher in men with ED. Most of the OR estimates on smoking–ED relationships were not statistically significant, probably due to small numbers. There are two bidirectional relations between ED and smoking. Those who smoked had a higher risk of ED than nonsmokers. The men with ED were more likely to start smoking than those free from ED. The estimates of effects were not statistically significant, but they were consistent with each other and with the hypothesis that smoking causes ED and ED causes smoking. The recovery from ED was less in smokers than among nonsmokers, and current smokers with ED were more likely to stop smoking than men free from ED. Numbers were few and estimates of effects were not significant, but consistent with the hypothesis of smoking preventing recovery from ED and ED improving the success of smoking cessation. Such transitions in four directions explain indirectly the known positive association between the prevalence of smoking and the prevalence of ED.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Ayta IA, McKinlay JB, Krane RJ . The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int 1999; 84: 50–56.

    Article  CAS  PubMed  Google Scholar 

  2. National Institutes of Health Consensus Conference. Impotence: National Institutes of Health Development Panel on impotence. JAMA 1993; 270: 83–90.

  3. Laumann EO, Paik A, Rosen RC . Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999; 281: 537–544.

    Article  CAS  PubMed  Google Scholar 

  4. Melman A, Gingell JC . The epidemiology and pathophysiology of erectile dysfunction. J Urol 1999; 161: 5–11.

    Article  CAS  PubMed  Google Scholar 

  5. Fugl-Meyer AR, Lodnert G, Branholm IB, Fugl-Meyer KS . Life satisfaction in male erectile dysfunction. Int J Impot Res 1997; 9: 141–148.

    Article  CAS  PubMed  Google Scholar 

  6. Jonler M et al. The effect of age, ethnicity and geographical location on impotence and quality of life. Br J Urol 1995; 75: 651–655.

    Article  CAS  PubMed  Google Scholar 

  7. Kaiser FE . Sexuality in the elderly. Urol Clin North Am 1996; 23: 99–109.

    Article  CAS  PubMed  Google Scholar 

  8. Wiley D, Bortz WM . Sexuality and aging: usual and successful. J Gerontol A: Biol Sci Med Sci 1996; 51: M142–M146.

    Article  CAS  Google Scholar 

  9. MacDonagh R, Ewings P, Porter T . The effect of erectile dysfunction on quality of life: psychometric testing of a new quality of life measure for patients with erectile dysfunction. J Urol 2002; 167: 212–217.

    Article  PubMed  Google Scholar 

  10. Ansong KS, Lewis C, Jenkins P, Bell J . Help-seeking decisions among men with impotence. Urology 1998; 52: 834–837.

    Article  CAS  PubMed  Google Scholar 

  11. Moreira Jr ED et al. Incidence of erectile dysfunction in men 40 to 69 years old: results from a population-based cohort study in Brazil. Urology 2003; 61: 431–436.

    Article  PubMed  Google Scholar 

  12. Johannes CB et al. Incidence of erectile dysfunction in men 40 to 69 years old: longitudinal results from the Massachusetts Male Ageing Study. J Urol 2000; 163: 460–463.

    Article  CAS  PubMed  Google Scholar 

  13. Feldman HA et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.

    Article  CAS  PubMed  Google Scholar 

  14. Feldman HA et al. Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts Male Aging Study. Prev Med 2000; 30: 328–338.

    Article  CAS  PubMed  Google Scholar 

  15. McVary KT, Carrier S, Wessells H . Smoking and erectile dysfunction: evidence based analysis. J Urol 2001; 166: 1624–1632.

    Article  CAS  PubMed  Google Scholar 

  16. Tengs TO, Osgood ND . The link between smoking and impotence: two decades of evidence. Prev Med 2001; 32: 447–452.

    Article  CAS  PubMed  Google Scholar 

  17. Morales AM et al. Prevalence and independent risk factors for erectile dysfunction in Spain. Results of the epidemiologia de la dysfunction erectile masculine study. J Urol 2001; 166: 569–574.

    Article  Google Scholar 

  18. Nicolosi A et al. Epidemiology of erectile dysfunction in four countries: cross-national study of the prevalence and correlates of erectile dysfunction. Urology 2003; 61: 201–206.

    Article  PubMed  Google Scholar 

  19. Akkus E et al. Prevalence and correlates of erectile dysfunction in Turkey: a population-based study. Eur Urol 2002; 41: 298–304.

    Article  PubMed  Google Scholar 

  20. Green JS et al. An investigation of erectile dysfunction in Gwent, Wales. BJU Int 2001; 88: 551–553.

    Article  CAS  PubMed  Google Scholar 

  21. Parazzini F et al. Frequency and determinants of erectile dysfunction in Italy. Eur Urol 2000; 37: 43–49.

    Article  CAS  PubMed  Google Scholar 

  22. Mannino DM, Klevens RM, Flanders WD . Cigarette smoking: an independent risk factor for impotence? Am J Epidemiol 1994; 140: 1003–1008.

    Article  CAS  PubMed  Google Scholar 

  23. Moreira Jr ED, Bestane WJ, Bartolo EB, Fittipaldi JA . Prevalence and determinants of erectile dysfunction in Santos, southeastern Brazil. Sao Paulo Med J 2002; 120: 49–54.

    Article  PubMed  Google Scholar 

  24. Pinnock CB, Stapleton AM, Marshall VR . Erectile dysfunction in the community: a prevalence study. Med J Aust 1999; 171: 353–357.

    CAS  PubMed  Google Scholar 

  25. Safarinejad MR . Prevalence and risk factors for erectile dysfunction in a population-based study in Iran. Int J Impot Res 2003; 15: 246–252.

    Article  CAS  PubMed  Google Scholar 

  26. Jeremy JY, Mikhailidis DP . Cigarette smoking and erectile dysfunction. J R Soc Health 1998; 118: 151–155.

    Article  CAS  Google Scholar 

  27. Bortolotti A, Parazzini F, Colli E, Landoni M . The epidemiology of erectile dysfunction and risk factors. Int J Androl 1997; 20: 323–334.

    Article  CAS  PubMed  Google Scholar 

  28. Fried LP, Moore RD, Pearson TA . Long-term effects of cigarette smoking and moderate alcohol consumption on coronary artery diameter: mechanism of coronary artery disease independent of arteriosclerosis or thrombosis? Am J Med 1986; 80: 37–44.

    Article  CAS  PubMed  Google Scholar 

  29. Shabsigh R, Fishaman IJ, Schum C, Dunn JK . Cigarette smoking and other vascular risk factors in vasculogenic impotence. Urology 1991; 38: 227–231.

    Article  CAS  PubMed  Google Scholar 

  30. Mikhailidis DP, Jeremy JY . Smoking and erectile impotence. Int Angiol 1993; 12: 297–298.

    CAS  PubMed  Google Scholar 

  31. Mirone V et al. Cigarette smoking as risk factor for erectile dysfunction: Results from an Italian epidemiological study. Eur Urol 2002; 41: 294–297.

    Article  PubMed  Google Scholar 

  32. Helakorpi S, Berg M-A, Uutela A, Puska P . Health Behavior Among Finnish Adult Population, Vol B8. National Public Health Institute, Helsinki, 1994 pp 13–95.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R Shiri.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shiri, R., Hakama, M., Häkkinen, J. et al. Relationship between smoking and erectile dysfunction. Int J Impot Res 17, 164–169 (2005). https://doi.org/10.1038/sj.ijir.3901280

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901280

Keywords

This article is cited by

Search

Quick links