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The Link Between Smoking and Erectile Dysfunction

Katelyn Hagerty

Reviewed by Katelyn Hagerty, FNP

Written by Geoffrey Whittaker

Published 03/12/2019

Updated 07/14/2023

If you’re a smoker and are having trouble in the bedroom, you may want to stub out your last cigarette before it chokes off your erections — for good.

The definitive link between smoking and erectile dysfunction (ED) is not only widely accepted within the medical community but also proven by research. Numerous studies have linked smoking to erectile dysfunction, largely due to the negative effects smoking can have on your overall health.

We’re not trying to be dorks about this, but it’s worth losing a few cool points to hammer it home that cigarettes are bad for your health — and the effects can start when you’re trying to light up the bedroom.

Smoking causes ED in men, regardless of age or any other variables. And while the occasional cigarette or cigar is unlikely to cause erectile dysfunction, regular smoking could seriously affect your sexual performance — we’re prepared to prove it.

Below, we’ll explain how smoking causes ED, list other problems it can cause for your sex life and discuss how to quit smoking if you’re struggling in the bedroom.

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Smoking — whether from tobacco products or the effects of nicotine products you get by vaping — is a clear and proven risk factor for erectile dysfunction. Make no mistake: Smoking can cause erectile dysfunction, contribute to sexual dysfunction and lead to various other health problems.

The dangers of ED, as they relate to smoking, are noted by the National Institutes of Health in numerous publications, alongside causes like obesity, stress, heart conditions, depression, anxiety and other medical conditions.

Meanwhile, the CDC connects tobacco use to everything from heart and lung diseases (duh) to low sperm count and infertility in men. No, these aren’t the same as erectile dysfunction, but they’re definitely neighbors who worry about each other’s homes collapsing — get it?

Smokers have a higher risk of erectile dysfunction overall, but some research suggests that how much you smoke can increase your risk level as well. A 2013 study found that heavy smokers (who are also typically at higher risk of cardiovascular disease and other health conditions) are more likely to see the negative effects of cigarette smoking on their intimate performance.

Many studies have associated erectile dysfunction with smoking behavior. What’s more, this condition has been associated with e-cigarettes, with evidence pointing to how nicotine contributes to ED (more on that in a moment).

As for the marijuana question, while there haven’t been as many studies about cannabis and ED, there’s strong evidence that marijuana presents an increased risk for ED. One study put the rate of ED among cannabis users as high as double the control groups.

Okay, have we (along with the hundreds of anti-smoking ads and cartoons you watched as a kid) convinced you that smoking is bad for you? If so, great. 

But just how does something that causes lung cancer, heart attacks and other terrible things affect your penis?

You might want to grab a piece of nicotine gum because the list is surprisingly long.

First and foremost, smoking cigarettes, cigars or pipe tobacco on a regular basis can damage your blood vessels, reducing arterial blood flow throughout your body. In other words, it’s really bad for your heart. 

The key culprit is nicotine, which is a known vasoconstrictor (something that reduces blood flow throughout the body). This can be seriously damaging to your sexual performance, as erections rely on a mix of signaling from your brain and a sufficient blood supply through the arteries of the penis.

When you feel sexually aroused, your brain sends a signal to the nerves in your penis. This triggers the opening of arteries, increasing blood flow to the corpus cavernosum — the spongy tissue of the penis that fills and hardens to form an erection.

Reduced blood flow from smoking or other unhealthy habits can make it much more difficult to achieve an erection, leaving you with a weak erection or no physical response at all to sexual arousal.

Research shows that the severity of erectile dysfunction in smokers is closely linked to their level of exposure to cigarette smoke — which is to say, the more you smoke, the worse your ED will be. It also appears to show that quitting smoking could help reduce or even eliminate ED symptoms.

More research needs to be done on vaping, but the available studies do show a link between vaping and negative sexual health outcomes, including ED

In one study from 2004, smokers and ex-smokers with erectile dysfunction were monitored for ongoing ED over the course of one year. The ex-smokers experienced a measurable reduction in erectile dysfunction symptoms, with an improvement in approximately 25 percent of study participants.

The smokers, on the other hand, saw no improvement — all who had erectile dysfunction at the beginning of the study also had it at the end. In fact, about 7 percent of the smokers who took part in the study experienced a worsening of their erectile dysfunction symptoms, compared to just 2.5 percent of non-smokers.

Other studies show similar results. A review of erectile dysfunction studies concluded that men who smoke have a higher risk of developing erectile dysfunction than non-smokers, regardless of age.

Smoking doesn’t just stop there. As mentioned, smoking can cause infertility, along with low sex drive and poor sexual stamina

Consider the following facts before you light up or vape again:

  • Smoking is linked to sperm damage and other fertility issues, as it causes inflammatory activity in the glands related to sperm production.

  • Analysis of data from nearly 7,000 men suggested a strong link between libido and smoking — men who smoked saw lower libido levels overall.

  • The same analysis also suggested that smokers regularly recorded less sexual activity overall. We have to assume that’s either because of the health effects of smoking or the reduced options due to bad breath.

In other words, if you don’t think smoking is ruining your sex life, you’re probably not paying attention. In the best-case scenario, you’re not seeing the consequences yet because there’s still time to prevent them. 

Let’s talk about how to do that.

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Most people with ED need to make changes and incorporate treatment into their lives. But treatment can range from serious forms like medication and therapy to something as simple as taking better care of yourself.

If you’re a smoker, you may not have been making the best health decisions. We’re not here to judge — we’re just here to show you what’ll work.

So, let’s start with the obvious: Quit smoking.

Quit or Reduce How Much You Smoke 

Fellas, this one may seem pretty obvious, but sometimes, it takes an obvious statement to call something out.

Smoking is the problem. If you’re a smoker, stop smoking — otherwise, these side effects will continue. We won’t drill the dangers of tobacco again, but when you’re repairing a boat, you start with the leaks.

ED could very well be leaking in with every puff you take, so stop puffing before you do anything else. There’s support available if you’ve tried to do this by yourself in the past without success.

FYI: Some treatments are better than others. Since a large part of erectile dysfunction caused by cigarettes is a result of the nicotine content, switching to a nicotine patch might not be entirely effective in preventing ED. A 2008 study even linked isolated nicotine (in the form of chewing gum) to erectile dysfunction.

What can you do? First, treat the source of the habit.

Many people smoke (or begin smoking) to ease feelings of stress. Taking care of your mental health concerns with online therapy is much healthier than pulling out your lighter. And as tobacco taxes continue to increase, we’d argue it’s becoming more affordable too — especially if you try it with us.

Some medications can also help with smoking cessation (a fancy term for quitting). For instance, take a look at what something like bupropion XL can do for you.

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Build Healthy Habits

While changing up your habits, why not look at the total body perspective on ED? 

ED can be related to poor general health, a sedentary lifestyle, too much drinking, frequent drug use, obesity and other whole-body health issues. With this in mind, you have to look at the big picture to effectively treat it.

Regular exercise, a healthy diet and a good night’s rest are great for your erectile health and your health, in general. Lifestyle changes can improve your vascular health and reduce high cholesterol over time, both of which can contribute to better sexual function.

Consider ED Medications

In some cases, quitting smoking might not be enough to restore full erectile function.

Erectile dysfunction drugs might be the most effective, safe and easy solution if your ED problems go beyond tobacco consumption. Luckily, a number of effective medications for ED are recommended by health professionals and approved by the FDA.

Smoking is closely linked to heart disease, high blood pressure and other cardiovascular conditions that can cause issues when combined with ED medication (like Viagra). Having said that, it’s best to talk to your doctor before considering these drugs.

Your healthcare provider may talk to you about Viagra, Cialis, Stendra or Levitra (or the generic versions of these medications, sildenafil, tadalafil, avanafil and vardenafil). Most are sold as tablets, though if you’re looking for convenient ways to take ED medication on date night, check out our chewable ED meds hard mints.

Talk to a Mental Health Provider

Mental health support isn’t just for people who want to quit smoking or those who are a little too stressed out. Online psychiatry can help with a number of things, including low self-esteem, performance anxiety and depression — three key risk factors for erectile dysfunction.

Whether you’re a smoker or not, your mental health plays a critical role in your erectile health and function, so don’t ignore it.

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If you’re nervously ashing your third cigarette while trying to figure out if you’ll ever get hard again, relax.

Yes, men who smoke have a higher risk of ED, but guys who quit smoking can — and very often do — experience improvements in sexual performance and a reduction in erectile dysfunction symptoms.

If you have erectile dysfunction as a result of cigarette smoking, the best course of action — we know this is going to sting a bit — is to quit smoking. 

In fact, it’s probably the most important of the three recommendations we’ll leave you with:

  • Stop smoking. Quitting cigarettes is usually the most effective erectile dysfunction treatment for people who smoke.

  • Adopt a healthier lifestyle. Taking up healthy habits, such as exercise (particularly aerobic exercise, which lowers blood pressure and is linked to improved sexual health), can help improve your ED.

  • Consider medication and/or therapy. Look into medications and therapy to treat the biological and mental risk factors for erectile dysfunction.

Need more help? Check out our sexual health resources for information about medications, symptoms and other issues related to intimacy, libido and erections.

11 Sources

  1. U.S. Department of Health and Human Services. (n.d.-g). Treatment for erectile dysfunction - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases.
  2. Mima, M., Huang, J. B., Andriole, G. L., Freedland, S. J., Ohlander, S. J., & Moreira, D. M. (2022). The impact of smoking on sexual function. BJU international, 130(2), 186–192.
  3. Kovac, J. R., Labbate, C., Ramasamy, R., Tang, D., & Lipshultz, L. I. (2015). Effects of cigarette smoking on erectile dysfunction. Andrologia, 47(10), 1087–1092.
  4. Black, C. E., Huang, N., Neligan, P. C., Levine, R. H., Lipa, J. E., Lintlop, S., Forrest, C. R., & Pang, C. Y. (2001). Effect of nicotine on vasoconstrictor and vasodilator responses in human skin vasculature. American journal of physiology. Regulatory, integrative and comparative physiology, 281(4), R1097–R1104.
  5. Pourmand, G., Alidaee, M. R., Rasuli, S., Maleki, A., & Mehrsai, A. (2004). Do cigarette smokers with erectile dysfunction benefit from stopping?: a prospective study. BJU international, 94(9), 1310–1313.
  6. Sooriyamoorthy T, Leslie SW. Erectile Dysfunction. [Updated 2023 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:
  7. Pizzol, D., Demurtas, J., Stubbs, B., Soysal, P., Mason, C., Isik, A. T., Solmi, M., Smith, L., & Veronese, N. (2019). Relationship Between Cannabis Use and Erectile Dysfunction: A Systematic Review and Meta-Analysis. American journal of men’s health, 13(6), 1557988319892464.
  8. Pincus, J., Sandoval, V., Dick, B., Sanekommu, G., Rajasekaran, R., Ramasamy, R., & Raheem, O. (2022). E-Cigarette-Associated Endothelial Damage: A Potential Mechanism for Erectile Dysfunction. Sexual medicine reviews, 10(1), 168–173.
  9. Cao, S., Yin, X., Wang, Y., Zhou, H., Song, F., & Lu, Z. (2013). Smoking and risk of erectile dysfunction: systematic review of observational studies with meta-analysis. PloS one, 8(4), e60443.
  10. U.S. Department of Health and Human Services. (n.d.-f). Symptoms & causes of erectile dysfunction - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases.
  11. Centers for Disease Control and Prevention. (2021, October 29). Health effects of cigarette smoking. Centers for Disease Control and Prevention.
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