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smoking and erections: can smoking cause erectile dysfunction?

by Janet Casperson, BS, MSN, ANP-C

Smoking affects both the quality and rigidity of erections and may be a significant cause of erectile dysfunction.

Tobacco abuse is one of our greatest health enemies. Smoking is responsible for over 400,000 deaths per year, making tobacco abuse the leading preventable cause of disability and death. Although the numbers of smokers are declining, many people continue to smoke.



The detrimental effects of tobacco are profound: cancer, hypertension, lung disease, asthma, allergies, heart disease, strokes, increased heart rate, shortness of breath, bladder and kidney disorders, digestive diseases, low birth weight in newborns, damage to performance and endurance in physical fitness, sexual dysfunction and as we have stated, erectile dysfunction.

Smoking and the quality of erections

We have often speculated that men would stop smoking if manufacturers put the following warning on the side of package, "WARNING: SMOKING WILL MAKE YOUR ERECTIONS GO AWAY." No man would smoke after that warning.

Randomized studies that look at the effects of smoking on erections and other sexual dysfunctions have not been well detailed in the literature. But through our extensive clinical practice we know that tobacco affects both the quality and rigidity of erections. We have seen severe end-stage erectile dysfunction in men with a long history of heavy smoking.

It is worth repeating that smoking is one of the biggest risk factors for both cardiovascular disease and erectile dysfunction. In any treatment regimen, it can't be tolerated. Efforts must be made to assist every patient with smoking cessation. We have actually witnessed some recovery of erectile function when men have successfully stopped smoking.

Smoking cessation and erectile dysfunction

There are many medications available for smoking cessation. One new drug in development is a cannabinoid antagonist which blocks the cannabinoid receptors in the brain. People who smoked marijuana (a cannabinoid) know that one side effect is "the munchies", or an urge to eat. Marijuana stimulates a certain center of the brain that stimulates obsessive behaviors including eating and smoking. Another new medication, rimonabant, blocks that receptor and has been associated with a dramatic weight loss and facilitating smoking cessation.

There is no other way to view tobacco in the situation of erectile dysfunction other than to say smoking should not be tolerated.

References: See Bibliography

August 2006
Posted August 2008
Updated December 2011


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