Any amount of smoking can contribute to erectile dysfunction. Smoking tobacco products can damage the circulatory system, making it harder for blood to reach the penis and create an erection.

This article will explain the link between smoking and erectile dysfunction (ED), its symptoms, and how doctors may diagnose and treat it. It will also offer some advice on how to stop smoking.

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Doctors describe ED as frequently or routinely having trouble achieving or keeping an erection that is firm enough for sex. Some people call it impotence. It affects as many as 30 million males in the United States.

When a male is sexually aroused, the body releases chemicals. These chemicals cause blood to flow into the spongy tissue in the penis.

The blood pressure keeps the penis firm, or erect, during sex. After ejaculation, the blood flows back into the male’s circulation, and the erection reduces.

Having limited blood flow to the penis interferes with this process.

Some things that may reduce blood flow to the penis include:

Other factors can also contribute to ED, including nerve damage to the genital area, cancer treatments, and mental health conditions such as anxiety and depression.

Learn more

Learn more about ED and its causes.

Tobacco smoke contains more than 7,000 chemicals. At least 250 of these are harmful to human health, and at least 69 are known carcinogens.

Smoking can contribute to ED. Smoking causes the blood vessels to constrict significantly. This reduces the blood’s ability to move around the body, including into the penis.

It also increases a person’s chances of developing health conditions that can cause ED. It can, for example, contribute to:

  • atherosclerosis
  • heart disease
  • high blood pressure
  • diabetes

Smokers are between one-and-a-half and two times more likely to experience ED than non-smokers.

Are menthol cigarettes ok?

According to the Centers of Disease Control (CDC), no tobacco product is safe.

Menthol cigarettes carry all the same risks as conventional cigarettes. They are not a healthier option, and can still contribute to ED.

Learn more

Learn more about ED and other substances.

Quitting smoking can help to improve ED in many cases. It can improve blood circulation, making it easier for the blood to move into, and stay in, the penis during sex.

It can also significantly reduce a person’s chances of developing:

How long after quitting does erectile dysfunction improve?

Researchers state that quitting smoking reduces the risk of erectile dysfunction. However, doctors are not sure how quickly quitting smoking can help to improve the symptoms of ED.

Many males could see a difference in around six months. However, it will depend on lots of things, including:

  • how long the person has smoked for
  • how much they smoked regularly
  • whether they have any other health conditions, such as heart disease or diabetes

However, smokers with severe ED may never regain normal erectile functioning, even after quitting. They may require medication and other treatments for ED.

The main symptom of ED is being unable to get or maintain an erection.

Of course, it is normal for this to happen from time to time. However, when it happens frequently or routinely, doctors call it ED.

ED can also cause:

If someone is regularly or routinely experiencing ED, it is usually a good idea to contact a doctor. It can be a sign of undiagnosed cardiovascular disease.

ED is not the only smoking-related sexual problem in males. This section looks at how smoking can affect a male’s sex life.

Decreased libido

Some studies have suggested that males who smoke have lower libidos, or sex drives, than males who do not smoke.

Decreased stamina

Smoking negatively impacts a person’s physical fitness, including stamina levels. This can affect sexual performance.

Low sperm count

Smoking can contribute to various sperm problems, including:

This can impact fertility.

To diagnose ED, doctors will usually ask about the person’s family and medical history, and about their lifestyle. The doctor will want to know if the person has any medical conditions and if they take any medications.

They will also ask about the symptoms and the person’s mental health.

The doctor may carry out a physical exam, focusing on the penis and testicles. They may order urinalysis or blood tests.

Treatment will depend on the cause of the problem. In the first instance, the doctor will usually recommend lifestyle changes.

That might include stopping smoking, cutting down on alcohol, or eating healthily. All this can help to increase blood flow in the body and to the penis.

Sometimes, doctors may recommend medication that increases blood flow to the penis.

Pills that can help with ED include:

In some cases, doctors may recommend alprostadil, which is an injection.

Learn more

Learn more about erectile dysfunction treatments.

Quitting smoking can be difficult, but lots of help is available.

The American Lung Foundation (ALF) says people can try:

  • Focusing on why they want to stop: Reasons might include improving ED symptoms and lengthening life expectancy, for example.
  • Managing stress: It may help to find alternative ways to manage stress or cope with negative emotions, such as meditation, yoga, or therapy.
  • Staying positive: It is important to not get discouraged by any failed attempts to quit in the past. Instead of dwelling on failure, people can think about what they have learned, and what they can do differently this time.
  • Reaching out: Asking for help from friends, family, or groups such as the ALF will help a person to stay on track with their quitting goals and get the support they need.

People can also talk with medical professionals about medications, such as nicotine replacement therapy, to help with withdrawal symptoms.

Learn more

Learn more about how to give up smoking and the benefits of quitting.

People can usually manage ED with lifestyle changes, such as stopping smoking. If this doesn’t work, doctors may recommend medication.

If an underlying condition is causing ED, such as high blood pressure or atherosclerosis, treating the condition with medication, diet changes, and exercise may alleviate ED.

If ED results from emotional causes, such performance anxiety, generalized anxiety disorder, or low mood, communicating openly with a partner and attending therapy may help a person overcome ED.

There are many different treatments available for ED. A person should discuss these options with a doctor.

This section looks at some frequently asked questions about smoking and erectile dysfunction.

Do smoking and drinking cause erectile dysfunction?

Smoking can cause ED because it damages the circulatory system and reduces blood flow.

Researchers are not clear on the link between drinking alcohol and ED.

However, studies have suggested that males who drink a lot are more likely to experience ED than those who do not drink, or who drink moderately.

Does smoking menthol cigarettes cause erectile dysfunction?

Menthol cigarettes carry all the same risks as conventional cigarettes. They are not a healthier option, and can still contribute to ED.

Will quitting smoking increase testosterone?

Researchers are unclear on the link between smoking and testosterone.

Smoking may lead to raised testosterone levels, which can cause low sperm count and ED.

A review of multiple studies, published in 2016, found that males who smoked had higher testosterone levels than those who didn’t. Doctors need more studies before they can be sure.

Smoking can damage blood flow to the penis, resulting in ED.

Smoking can also contribute to health conditions that can cause ED, such as heart disease and type 2 diabetes.

Stopping smoking can improve the symptoms of ED. It can also help prevent a range of health conditions, including many types of cancer.

If quitting does not solve the problem, doctors may recommend medications to treat ED, such as Viagra.

In severe, unresponsive ED, doctors may recommend injectable medication or surgical implants.

References

Diagnosis of erectile dysfunction. (2017). https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/diagnosis

Harms of cigarette smoking and health benefits of quitting. (2017). https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/cessation-fact-sheet

Health effects. (2020). https://www.cdc.gov/tobacco/basic_information/health_effects/index.htm

Hehemann, M., et al. (2016). Can lifestyle modification affect men’s erectile function? https://ncbi.nlm.nih.gov/pmc/articles/PMC4837314/

How smoking affects your workout. (n.d.). https://smokefree.gov/quit-smoking/why-you-should-quit/how-smoking-affects-your-workout

Kovac, J., et al. (2016). Effects of cigarette smoking on erectile dysfunction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485976/

Menthol tobacco products are a public health problem. (2022). https://www.cdc.gov/tobacco/basic_information/menthol/public-health-problem.html

Tang, Q., et al. (2019). Semen quality and cigarette smoking in a cohort of healthy fertile men. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693933/

Top tips for quitting smoking. (2020). https://www.lung.org/quit-smoking/i-want-to-quit/top-tips-for-quitting-smoking

Treatment for erectile dysfunction. (2017). https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment

What is erectile dysfunction? (2018). https://www.urologyhealth.org/urology-a-z/e/erectile-dysfunction-(ed)

Yafi, F., et al. (2016). Erectile dysfunction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027992/

Zhau, J., et al. (2016). Cigarette smoking and testosterone in men and women: A systematic review and meta-analysis of observational studies. https://www.sciencedirect.com/science/article/abs/pii/S0091743515003941?via%3Dihub