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Association between cigarette smoking and erectile tumescence: the mediating role of heart rate variability

Abstract

Cigarette smoking deleteriously affects erectile function, and conversely, quitting smoking improves erectile hemodynamics. Underlying mechanisms by which smoking (or reduction of smoking frequency) may affect erectile physiology are not well understood. This study examined the mediating role of heart rate variability (HRV; a marker of sympathovagal balance) among a sample of male chronic smokers from the United States. Sixty-two healthy men (Mage=38.27 years; s.d.=10.62) were assessed at baseline (while smoking regularly), at mid-treatment (while using a nicotine patch) and at follow-up, 4 weeks after patch discontinuation. Cigarette use, frequency-domain parameters of HRV (low frequency (LF), high frequency (HF), LF/HF ratio) and physiological sexual arousal responses (via penile plethysmography) were assessed at each visit. Results were consistent with mediation, in that greater reductions in cigarette use from baseline to follow-up were associated with longitudinal increases in LF, which in turn showed positive relationships with across-time changes in erectile tumescence. Neither HF nor LF/HF ratio mediated the relationship between smoking and erection. In conclusion, HRV mediated the inverse relationship between reductions in smoking and enhancements in erectile tumescence. Results underscore the possibility that cigarette use may deleteriously affect erectile function peripherally, in part, by disrupting cardiac autonomic function.

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Acknowledgements

This project was supported by Award Number F31DA026276 from the National Institute on Drug Abuse (NIDA) to Christopher Harte. The contents of this work are solely the responsibility of the author and do not necessarily represent the official views of the NIDA or the National Institutes of Health. Portions of this work were also made possible by Grant Number 1 RO1 HD051676-01 A1 to Cindy M Meston from the National Institute of Child Health and Human Development (NICHD). The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NICHD. This project was also supported by the following fellowships/awards to the first author: The Sexual Medicine Society of North America Student Research Grant; two Graduate Dean’s Prestigious Fellowship Supplements, and a College of Liberal Arts Graduate Research Fellowship, all from the University of Texas at Austin; the American Psychological Association Dissertation Research Award; and The Kinsey Institute Student Research Grant. We thank Tyler Watts, Hillary Perlman, Olivia Bentkowski, Alicia Whitaker, Gail Dalton and Katy Siciliano for help with participant recruitment, screening and data management.

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Correspondence to C B Harte.

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Harte, C., Meston, C. Association between cigarette smoking and erectile tumescence: the mediating role of heart rate variability. Int J Impot Res 25, 155–159 (2013). https://doi.org/10.1038/ijir.2012.43

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Keywords

  • erectile function
  • heart rate variability
  • mediation
  • penile hemodynamics
  • smoking
  • smoking cessation

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