Table of ContentsView AllTable of ContentsCan Nicotine Cause ED?What Is the Risk?Other Sexual ProblemsOther Causes of EDTreatmentsQuitting Cigarettes
Table of ContentsView All
View All
Table of Contents
Can Nicotine Cause ED?
What Is the Risk?
Other Sexual Problems
Other Causes of ED
Treatments
Quitting Cigarettes
Nicotine—whether smoked,vaped, orchewed—anderectile dysfunction (ED)are closely linked. This is because nicotine causes the narrowing of blood vessels and reduces circulation throughout the body, including thepenis. The restrictions of blood flow to the penis impair your ability to get and sustain an erection, resulting in ED.
This article explains how nicotine affects the body and how it contributes to ED. It also discusses other ways that ED affects sex and offers tips for how to quit smoking once and for all.
Eva-Katalin / Getty Images
Nicotine is a highly addictive stimulant found in tobacco. It is the substance that produces feelings of pleasure when it is smoked,vaped, chewed, or used as snuff.
Other chemical toxins created from cigarette smoke decrease levels of a compound called nitric oxide in the blood. This is the compound responsible forvasodilation(the widening of blood vessels) which enables the engorgement of the penis with blood during anerection.
Over time, the continued constriction of blood vessels can cause them to stiffen, sometimes permanently.
Other contributing factors include the dysfunction of nerves that regulate the sexual response and erections (neurogenic ED) and psychological issues that affectlibidoand sexual desire (psychogenic ED). Multiple mechanisms are sometimes involved.
What Is the Risk of ED From Nicotine?
Irrespective of how nicotine enters your body, it has the potential to cause or contribute to ED. Here is what some of the current research says:
Risk Is Dose-Dependent
The risk of ED from nicotine is dose-dependent, meaning that the more nicotine that enters your body, the greater the effect.
A 2015 review of studies from Baylor University reported that males who smoked more than 20 cigarettes per day had double the risk of severe ED than those who smoked less.
To this end, a 29-pack-year history of smoking was shown to significantly increase the risk of ED compared to a 12-pack-year history of smoking which has more or less the same level of risk as a non-smoker.
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Other Ways Nicotine Affects Sex
Cigarettes affect more than just the ability to achieve or sustain an erection. According to a 2022 study published inBJU International,which involved 6,754 males between the ages of 50 and 75, smoking was associated with an 80% increased risk oflow libido(sex drive) compared to not smoking.
The loss of libido in female smokers is well known as it reduces levels of the hormoneestrogen, which influences libido.The cause of the loss of libido in male smokers is less understood.
Another small study conducted in 2020 found that nicotine addiction not only increased the risk of ED and low libido but also contributed to delayed orgasm andanorgasmia(inability to achieve orgasm).
Does Nicotine Keep You Awake?
Additional Causes of Erectile Dysfunction
Aside from smoking, other possible causes of erectile dysfunction include:
You may experience ED from any one (or a combination) of these conditions. On the flip side, smoking is a contributing factor to diabetes, high blood pressure, and heart disease, whether ED is involved or not.
Nicotine Gum: What Is Bad for You When You Are Quitting Smoking?
How to Maintain an Erection
If you have erectile dysfunction, there are several treatment options you can pursue depending on how severe your condition is, including:
Given that the quality of your health influences the risk of ED, there are other lifestyle changes you can make to improve your sexual function:
You also need to address your mental health if you are feeling anxious or depressed about ED. Stress compounds ED and, in some cases, is the sole cause of ED (especially in younger males).
If you are having trouble achieving or maintaining an erection, speak with your partner and work together to find a solution. This alone can reduce the risk of sexualperformance anxiety.Stress reduction techniqueslike deep breathing exercises, yoga, and meditation may also help.
If anxiety or depression is getting the better of you, consider seeing a therapist who can provide counseling and help pinpoint the underlying psychological causes of your ED.
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How to Quit Smoking
Quitting cigarettes is one of the most important things you can do if you have erectile dysfunction. Studies have shown that ED significantly improves within six months to a year of quitting cigarettes, even among heavy smokers.
Quitting smokingis not easy, and doing cold turkey doesn’t always work. In the end, it takes an average of five to seven quit attempts for most people to finally quit.
To improve your chances, speak with your healthcare provider about over-the-counter and prescriptionsmoking cessation aidsthat can help, including:
E-cigarettes are not considered an effective quitting tool–and may only continue to contribute to ED.While nicotine patches, gum, lozenges, and sprays may do the same, the benefits of smoking cessation more than outweigh the short-term risks of ED.
Speak with your insurance provider as many smoking cessation aids are covered as anEssential Health Benefitunder the Affordable Care Act, even after multiple attempts.
In-person and online smoking cessation support groups may also help.
Summary
Smoking can shrink blood vessels and restrict blood flow to the penis, causing erectile dysfunction. Other conditions can contribute, such as diabetes and high blood pressure. There are ED medications that can help, but certain lifestyle changes—most notably quitting cigarettes—can improve your chances of achieving and sustaining erections over the long term.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wölkart G, Kollau A, Russwurm M, et al.Varied effects of tobacco smoke and e-cigarette vapor suggest that nicotine does not affect endothelium-dependent relaxation and nitric oxide signaling.Sci Rep.2023:13:15833. doi:10.1038/s41598-023-42750-6Kovac JR, Labbate C, Ramasamy R, Tang D, Lipshultz LI.Effects of cigarette smoking on erectile dysfunction.Andrologia. 2015;47(10):1087-1092. doi:10.1111/and.12393El-Shahawy O, Shah T, Obisesan OH, et al.Association of e-cigarettes with erectile dysfunction: The population assessment of tobacco and health study.Am J Prev Med. 2022 Jan;62(1):26-38. doi:10.1016/j.amepre.2021.08.004Bongongo T, Jeewa Y, Nzummvila DK, Govender I.Awareness of health risks associated with smokeless tobacco use among users in Pretoria.S Afr Fam Pract.2022;64(1):5560. doi:10.4102/safp.v64i1.5560Skaug EA, Nes B, Aspenes ST, Ellingsen O.Non-smoking tobacco affects endothelial function in healthy men in one of the largest health Studies ever performed; the Nord-Trøndelag Health Study in Norway; HUNT3.PLoS One.2016;11(8):e0160205. doi:10.1371/journal.pone.0160205Allen MS, Tostes RC,Cigarette smoking and erectile dysfunction: an updated review with a focus on pathophysiology, e-cigarettes, and smoking cessation,Sex Medicines Rev.2023:11(1):61-73.doi:10.1093/sxmrev/qeac007Mima M, Huang JB, Andriole GL, Freedland SJ, Ohlander SJ, Moreira DM.The impact of smoking on sexual function.BJU Int.2022 Aug;130(2):186-192. doi:10.1111/bju.15711Ethier AR, McKinney TL, Tottenham LS, et al.The effect of reproductive hormones on women’s daily smoking across the menstrual cycle.Biol Sex Differ.2021:12:41. doi:10.1186/s13293-021-00384-1Bhattacharyya R, Sanyal D, Bhattacharyya S, Chakraborty K, Neogi R, Banerjee BB.Depression, sexual dysfunction, and medical comorbidities in young adults having nicotine dependence.Indian J Community Med.2020 Jul-Sep;45(3):295–298. doi:10.4103/ijcm.IJCM_153_19El-Sherbiny NA, Elsary AY.Smoking and nicotine dependence in relation to depression, anxiety, and stress in Egyptian adults.J Fam Community Med.2022:29(1):8-16. doi:10.4103/jfcm.jfcm_290_21Rew KT, Heidelbaugh JJ.Erectile dysfunction.Am Fam Physician. 2016;94(10):820-827.Johns Hopkins Medicine.Smoking and cardiovascular disease.Harvard Health.5 natural ways to overcome erectile dysfunction.Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri C.Stress management and erectile dysfunction: a pilot comparative study.Andrologia. 2013;46(6):698-702. doi:10.1111/and.12129Chaiton M, Diemart L, Cohen JE, et al.Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers.BMJ Open.2016;6(6):e011045. doi:10.1136/bmjopen-2016-011045MD Anderson Cancer Center.Quit smoking: 6 products to strike out nicotine.American Lung Association.Tobacco cessation treatment: what is covered?
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wölkart G, Kollau A, Russwurm M, et al.Varied effects of tobacco smoke and e-cigarette vapor suggest that nicotine does not affect endothelium-dependent relaxation and nitric oxide signaling.Sci Rep.2023:13:15833. doi:10.1038/s41598-023-42750-6Kovac JR, Labbate C, Ramasamy R, Tang D, Lipshultz LI.Effects of cigarette smoking on erectile dysfunction.Andrologia. 2015;47(10):1087-1092. doi:10.1111/and.12393El-Shahawy O, Shah T, Obisesan OH, et al.Association of e-cigarettes with erectile dysfunction: The population assessment of tobacco and health study.Am J Prev Med. 2022 Jan;62(1):26-38. doi:10.1016/j.amepre.2021.08.004Bongongo T, Jeewa Y, Nzummvila DK, Govender I.Awareness of health risks associated with smokeless tobacco use among users in Pretoria.S Afr Fam Pract.2022;64(1):5560. doi:10.4102/safp.v64i1.5560Skaug EA, Nes B, Aspenes ST, Ellingsen O.Non-smoking tobacco affects endothelial function in healthy men in one of the largest health Studies ever performed; the Nord-Trøndelag Health Study in Norway; HUNT3.PLoS One.2016;11(8):e0160205. doi:10.1371/journal.pone.0160205Allen MS, Tostes RC,Cigarette smoking and erectile dysfunction: an updated review with a focus on pathophysiology, e-cigarettes, and smoking cessation,Sex Medicines Rev.2023:11(1):61-73.doi:10.1093/sxmrev/qeac007Mima M, Huang JB, Andriole GL, Freedland SJ, Ohlander SJ, Moreira DM.The impact of smoking on sexual function.BJU Int.2022 Aug;130(2):186-192. doi:10.1111/bju.15711Ethier AR, McKinney TL, Tottenham LS, et al.The effect of reproductive hormones on women’s daily smoking across the menstrual cycle.Biol Sex Differ.2021:12:41. doi:10.1186/s13293-021-00384-1Bhattacharyya R, Sanyal D, Bhattacharyya S, Chakraborty K, Neogi R, Banerjee BB.Depression, sexual dysfunction, and medical comorbidities in young adults having nicotine dependence.Indian J Community Med.2020 Jul-Sep;45(3):295–298. doi:10.4103/ijcm.IJCM_153_19El-Sherbiny NA, Elsary AY.Smoking and nicotine dependence in relation to depression, anxiety, and stress in Egyptian adults.J Fam Community Med.2022:29(1):8-16. doi:10.4103/jfcm.jfcm_290_21Rew KT, Heidelbaugh JJ.Erectile dysfunction.Am Fam Physician. 2016;94(10):820-827.Johns Hopkins Medicine.Smoking and cardiovascular disease.Harvard Health.5 natural ways to overcome erectile dysfunction.Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri C.Stress management and erectile dysfunction: a pilot comparative study.Andrologia. 2013;46(6):698-702. doi:10.1111/and.12129Chaiton M, Diemart L, Cohen JE, et al.Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers.BMJ Open.2016;6(6):e011045. doi:10.1136/bmjopen-2016-011045MD Anderson Cancer Center.Quit smoking: 6 products to strike out nicotine.American Lung Association.Tobacco cessation treatment: what is covered?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Wölkart G, Kollau A, Russwurm M, et al.Varied effects of tobacco smoke and e-cigarette vapor suggest that nicotine does not affect endothelium-dependent relaxation and nitric oxide signaling.Sci Rep.2023:13:15833. doi:10.1038/s41598-023-42750-6Kovac JR, Labbate C, Ramasamy R, Tang D, Lipshultz LI.Effects of cigarette smoking on erectile dysfunction.Andrologia. 2015;47(10):1087-1092. doi:10.1111/and.12393El-Shahawy O, Shah T, Obisesan OH, et al.Association of e-cigarettes with erectile dysfunction: The population assessment of tobacco and health study.Am J Prev Med. 2022 Jan;62(1):26-38. doi:10.1016/j.amepre.2021.08.004Bongongo T, Jeewa Y, Nzummvila DK, Govender I.Awareness of health risks associated with smokeless tobacco use among users in Pretoria.S Afr Fam Pract.2022;64(1):5560. doi:10.4102/safp.v64i1.5560Skaug EA, Nes B, Aspenes ST, Ellingsen O.Non-smoking tobacco affects endothelial function in healthy men in one of the largest health Studies ever performed; the Nord-Trøndelag Health Study in Norway; HUNT3.PLoS One.2016;11(8):e0160205. doi:10.1371/journal.pone.0160205Allen MS, Tostes RC,Cigarette smoking and erectile dysfunction: an updated review with a focus on pathophysiology, e-cigarettes, and smoking cessation,Sex Medicines Rev.2023:11(1):61-73.doi:10.1093/sxmrev/qeac007Mima M, Huang JB, Andriole GL, Freedland SJ, Ohlander SJ, Moreira DM.The impact of smoking on sexual function.BJU Int.2022 Aug;130(2):186-192. doi:10.1111/bju.15711Ethier AR, McKinney TL, Tottenham LS, et al.The effect of reproductive hormones on women’s daily smoking across the menstrual cycle.Biol Sex Differ.2021:12:41. doi:10.1186/s13293-021-00384-1Bhattacharyya R, Sanyal D, Bhattacharyya S, Chakraborty K, Neogi R, Banerjee BB.Depression, sexual dysfunction, and medical comorbidities in young adults having nicotine dependence.Indian J Community Med.2020 Jul-Sep;45(3):295–298. doi:10.4103/ijcm.IJCM_153_19El-Sherbiny NA, Elsary AY.Smoking and nicotine dependence in relation to depression, anxiety, and stress in Egyptian adults.J Fam Community Med.2022:29(1):8-16. doi:10.4103/jfcm.jfcm_290_21Rew KT, Heidelbaugh JJ.Erectile dysfunction.Am Fam Physician. 2016;94(10):820-827.Johns Hopkins Medicine.Smoking and cardiovascular disease.Harvard Health.5 natural ways to overcome erectile dysfunction.Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri C.Stress management and erectile dysfunction: a pilot comparative study.Andrologia. 2013;46(6):698-702. doi:10.1111/and.12129Chaiton M, Diemart L, Cohen JE, et al.Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers.BMJ Open.2016;6(6):e011045. doi:10.1136/bmjopen-2016-011045MD Anderson Cancer Center.Quit smoking: 6 products to strike out nicotine.American Lung Association.Tobacco cessation treatment: what is covered?
Wölkart G, Kollau A, Russwurm M, et al.Varied effects of tobacco smoke and e-cigarette vapor suggest that nicotine does not affect endothelium-dependent relaxation and nitric oxide signaling.Sci Rep.2023:13:15833. doi:10.1038/s41598-023-42750-6
Kovac JR, Labbate C, Ramasamy R, Tang D, Lipshultz LI.Effects of cigarette smoking on erectile dysfunction.Andrologia. 2015;47(10):1087-1092. doi:10.1111/and.12393
El-Shahawy O, Shah T, Obisesan OH, et al.Association of e-cigarettes with erectile dysfunction: The population assessment of tobacco and health study.Am J Prev Med. 2022 Jan;62(1):26-38. doi:10.1016/j.amepre.2021.08.004
Bongongo T, Jeewa Y, Nzummvila DK, Govender I.Awareness of health risks associated with smokeless tobacco use among users in Pretoria.S Afr Fam Pract.2022;64(1):5560. doi:10.4102/safp.v64i1.5560
Skaug EA, Nes B, Aspenes ST, Ellingsen O.Non-smoking tobacco affects endothelial function in healthy men in one of the largest health Studies ever performed; the Nord-Trøndelag Health Study in Norway; HUNT3.PLoS One.2016;11(8):e0160205. doi:10.1371/journal.pone.0160205
Allen MS, Tostes RC,Cigarette smoking and erectile dysfunction: an updated review with a focus on pathophysiology, e-cigarettes, and smoking cessation,Sex Medicines Rev.2023:11(1):61-73.doi:10.1093/sxmrev/qeac007
Mima M, Huang JB, Andriole GL, Freedland SJ, Ohlander SJ, Moreira DM.The impact of smoking on sexual function.BJU Int.2022 Aug;130(2):186-192. doi:10.1111/bju.15711
Ethier AR, McKinney TL, Tottenham LS, et al.The effect of reproductive hormones on women’s daily smoking across the menstrual cycle.Biol Sex Differ.2021:12:41. doi:10.1186/s13293-021-00384-1
Bhattacharyya R, Sanyal D, Bhattacharyya S, Chakraborty K, Neogi R, Banerjee BB.Depression, sexual dysfunction, and medical comorbidities in young adults having nicotine dependence.Indian J Community Med.2020 Jul-Sep;45(3):295–298. doi:10.4103/ijcm.IJCM_153_19
El-Sherbiny NA, Elsary AY.Smoking and nicotine dependence in relation to depression, anxiety, and stress in Egyptian adults.J Fam Community Med.2022:29(1):8-16. doi:10.4103/jfcm.jfcm_290_21
Rew KT, Heidelbaugh JJ.Erectile dysfunction.Am Fam Physician. 2016;94(10):820-827.
Johns Hopkins Medicine.Smoking and cardiovascular disease.
Harvard Health.5 natural ways to overcome erectile dysfunction.
Kalaitzidou I, Venetikou MS, Konstadinidis K, Artemiadis AK, Chrousos G, Darviri C.Stress management and erectile dysfunction: a pilot comparative study.Andrologia. 2013;46(6):698-702. doi:10.1111/and.12129
Chaiton M, Diemart L, Cohen JE, et al.Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers.BMJ Open.2016;6(6):e011045. doi:10.1136/bmjopen-2016-011045
MD Anderson Cancer Center.Quit smoking: 6 products to strike out nicotine.
American Lung Association.Tobacco cessation treatment: what is covered?
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