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What role does smoking play in erectile dysfunction?

Want to be smoking hot in the bedroom but unable to perform? It might be the ciggies.

Written by
Kylie Saunder
Medically reviewed by
Last updated
August 23, 2023
min read
What role does smoking play in erectile dysfunction?
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Want to be smoking hot in the bedroom but unable to perform?

If you’re a smoker and are having issues achieving or maintaining an erection, it’s important to know that there is a link between cigarette smoking and erectile dysfunction.

In 2001, a study looked at over two decades of research to determine if anti-tobacco advertisements that featured vasculogenic impotence as a side effect of smoking was accurate.

In-depth analysis of over 1000 journal articles found that "40 per cent of impotent men were current smokers compared with 28 per cent of men in the general population".

While this has statistical significance, the clear message is this: Quitting smoking will improve your sexual performance, sexual health and erection dysfunction (ED) status.

While most cigarette smokers know they're at higher risk of health issues, it's good to know why. Tobacco smoke contains over 7,000 chemicals, including 250 harmful chemicals like ammonia, hydrogen cyanide and carbon monoxide.

These chemicals enter your lungs and spread throughout your body within 10 seconds when you smoke.

Smoking has many adverse effects on your body, many of which can lead to life-threatening complications. They include:

  • Lung damage that can lead to lung cancer
  • Vascular risk factors including coronary artery disease and heart disease
  • Fertility problems
  • Sexual dysfunction
  • Increased risk of developing Type 2 diabetes
  • Weakened immune system
  • Unhealthy skin and hair
  • Increased risk of gum disease
  • Stained and unhealthy teeth.

In this article, we’ll break down the connection between smoking and erectile dysfunction and give you some reasons as to why it might be time to quit smoking if you’re affected by erectile dysfunction.

Can smoking cause erectile dysfunction?

Did you know that erectile dysfunction affects 40 per cent of men? ED (short for erectile dysfunction) is defined as:

  • Trouble getting an erection
  • Trouble keeping an erection
  • A reduced desire for sex.

But if you’re a smoker, the likelihood of developing erectile dysfunction increases.

A 2015 study found, “cigarette smoking can lead to cardiovascular dysfunction and is now established to be an independent risk factor for the development of erectile dysfunction.”

Over the last few decades, numerous studies have supported the link between smoking and erectile dysfunction.

Tobacco use is now recognised as a significant risk factor for ED, with the 2014 US Surgeon General’s report stating that smoking causes erectile dysfunction.

The Tobacco in Australia report compiled by the Cancer Council Victoria states, “Vasospasm induced by the nicotine in cigarette smoke has been suggested as a mechanism for the acute deleterious effects of smoking on erectile function, while the chronic effects are caused by impaired vascular physiology of the erectile tissue.”

Simply put, smoking can cause erectile dysfunction.

So, if you’re a smoker and affected by ED, how many cigarettes, cigars or pipe tobacco can damage your blood vessels and reduce the arterial blood flow throughout your body?

In 2005, an Italian study showed that patients who developed erectile dysfunction “showed a significant difference when men smoked greater than 10 cigarettes per day.”

And for younger patients, who smoked more than 20 cigarettes a day (classified as heavy smokers) the likelihood of developing severe erectile dysfunction doubled.

A Western Australian study in 2009 has also indicated that a daily intake of cigarettes increased the likelihood of developing ED.

What are other common causes of erectile dysfunction?

Male sexual arousal depends on processes that involve your hormones, brain, nerves, blood vessels and muscles.

While ED symptoms can be caused by heavy smoking and alcohol consumption, The Mayo Clinic has identified several other physical and psychological causes of erectile dysfunction.

Common physical causes of erectile dysfunction include:

  • Atherosclerosis (clogged blood vessels)
  • Diabetes
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Low levels of testosterone
  • Metabolic syndrome (a condition with increased blood pressure, body fat around the waist, high cholesterol, and high insulin levels)
  • Multiple sclerosis
  • Obesity
  • Parkinson’s disease
  • Peyronie’s disease (a condition where scar tissue develops inside the penis)
  • Sleep disorders
  • Smoking tobacco
  • Some prescription medication
  • Surgeries or injuries that affect the spinal cord or pelvic area.

Common psychological causes of erectile dysfunction include:

  • Stress
  • Depression, or other mental health conditions
  • Anxiety about sexual performance is common at the start of a new relationship but can also occur if you've had previous issues with erectile dysfunction and sexual performance
  • Relationship problems that result from poor communication, financial worries, health stress or other concerns can be a factor to develop ED.

In some cases of ED, a combination of physical and physiological issues is at play. For example, a minor bodily injury that reduces your sexual response can create anxiety about maintaining an erection.

The Massachusetts male ageing study looked at the odds ratio of developing ED in men 40 to 69 years old.

The follow-up study in 2000 showed, "the risk of erectile dysfunction was about 26 cases per 1,000 men annually, and increased with age, lower education, diabetes, heart disease and hypertension."

So what's the significance of this study for cigarette smokers and heavy smokers? The odds ratio of developing ED increases dramatically.

Need help with your erectile function? Pilot's erectile dysfunction treatment is created by Australian practitioners to suit your personal circumstances and after an online consultation, can be delivered discreetly to your door.

How quitting smoking can improve erectile dysfunction

Wondering if it’s worthwhile quitting smoking to improve your ED? A 2009 study of 1,580 participants explored the relationship between erectile dysfunction, cigarette smoking and cardiovascular disease.

Former and current smokers had significantly higher odds of ED when compared to participants who never smoked.

A 2004 study assessed whether quitting smoking can improve ED and found “the severity of ED correlated significantly with the level of exposure to smoking.”

After 12 months, erectile dysfunction improved in greater than 25 per cent of ex-smokers but not current smokers. This study proves the strong correlation between smoking intensity and the degree of erectile dysfunction.

How long after quitting smoking does erectile dysfunction improve?

Ready to quit smoking but curious to know how quickly your ED will improve? A 2020 study evaluated the effects of smoking cessation on sexual functions in men aged 30 to 60 years of age.

The participants were assessed before they quit smoking and six months after they quit. Results showed “erectile function is directly proportional to the degree of exposure to smoking, and quitting smoking improves male sexual function in all age groups between 30-60 years of age.”

Treatment options for erectile dysfunction

Erectile dysfunction can be treated using pills, injections, physical and psychological treatments. In some cases, a combination of treatments is used.

Your doctor must treat any underlying health conditions causing erectile dysfunction. Any erectile dysfunction treatment should also consider your lifestyle, diet, amount of exercise you do and your medical history.

Our erectile dysfunction treatment is delivered by Australian practitioners and is guided by the Royal Australian College of GPs standards of prescribing.

Under Australian law, we cannot provide information about the types of erection medication we prescribe. During the consultation with one of our practitioners, you’ll be able to ask questions like:

  • How do the erection pills work?
  • What brand of erection pills is best for your ED?
  • Are there any contraindications with ED pills and your current medications?

Our doctors will also uncover whether alcohol consumption is an important risk factor contributing to your inability to achieve or maintain a penile erection.

It’s important to note that you should only purchase erectile dysfunction medications online from authorised Australian prescribers like Pilot.

Erection medications bought on the Internet may be of inferior quality and could contain ingredients that aren’t safe for your health condition.

Need some motivation to quit smoking to improve your erectile dysfunction? A 2004 study found “stopping cigarette smoking can improve ED in a considerable proportion of smokers.”

Giving up smoking can be challenging, and it will take a few attempts for many people. Your withdrawal symptoms may make you feel tired, tense, and irritable.

Seeking out professional support from the Cancer Council may help you quit smoking for good. Discreetly delivered, Pilot can create a prescription treatment plan to treat your erection problems. Let’s get you smoking hot in the bedroom again!

Photo Credit: 20th Century Fox


1. https://www.health.gov.au/health-topics/smoking-and-tobacco/about-smoking-and-tobacco/what-are-the-effects-of-smoking-and-tobacco

2. https://www.researchgate.net/publication/230237786_Male_Erectile_Dysfunction_Its_Prevalence_in_Western_Australia_and_Associated_Sociodemographic_Factors

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485976/

4. https://www.tobaccoinaustralia.org.au/chapter-3-health-effects/3-6-reproductive-health-and-smoking

5. https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776

6. Austoni, E., Mirone, V., Parazzini, F., Fasolo, C.B., Turchi, P., Pescatori, E.S., Ricci, E., Gentile, V., Andrology Prevention Week centres and Italian Society of Andrology (2005). Smoking as a risk factor for erectile dysfunction: data from the Andrology Prevention Weeks 2001-2002 a study of the Italian Society of Andrology (s.I.a.). European Urology, [online] 48(5), pp.810–817; discussion 817-818. doi:10.1016/j.eururo.2005.03.005.

7. Biebel, M.G., Burnett, A.L. and Sadeghi-Nejad, H. (2016). Male Sexual Function and Smoking. Sexual Medicine Reviews, [online] 4(4), pp.366–375. doi:10.1016/j.sxmr.2016.05.001.

8. Chew, K.-K., Bremner, A., Stuckey, B., Earle, C. and Jamrozik, K. (2009). Is the Relationship Between Cigarette Smoking and Male Erectile Dysfunction Independent of Cardiovascular Disease? Findings from a Population-Based Cross-Sectional Study. The Journal of Sexual Medicine, 6(1), pp.222–231. doi:10.1111/j.1743-6109.2008.00971.x.

9. Kovac, J.R., Labbate, C., Ramasamy, R., Tang, D. and Lipshultz, L.I. (2014). Effects of cigarette smoking on erectile dysfunction. Andrologia, [online] 47(10), pp.1087–1092. doi:10.1111/and.12393.

10. National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health (2014). The Health Consequences of Smoking—50 Years of Progress. [online] Nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK179276/.

11. Pourmand, G., Alidaee, M.R., Rasuli, S., Maleki, A. and Mehrsai, A. (2004). Do cigarette smokers with erectile dysfunction benefit from stopping?: a prospective study. BJU International, 94(9), pp.1310–1313. doi:10.1111/j.1464-410x.2004.05162.x.

12. Tengs, T.O. and Osgood, N.D. (2001). The Link between Smoking and Impotence: Two Decades of Evidence. Preventive Medicine, 32(6), pp.447–452. doi:10.1006/pmed.2001.0830.

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