Can Nicotine Cause Erectile Dysfunction?

Published on September 16, 2021

Medically reviewed by Jamin Brahmbhatt, MD

Nicotine—whether smoked or vaped—has a vasoconstrictive effect on the body, meaning it shrinks and tightens blood vessels and reduces the amount of blood that can flow through them. Since an erection depends on strong blood flow to happen, smoking can potentially lead to erectile dysfunction (ED).

This article will discuss how smoking works against a healthy erection and offer tips for how to improve your overall and sexual health.

a man smoking outside at a cafe — Eva-Katalin / Getty Images

Can Nicotine Cause ED?

Nicotine is a highly addictive stimulant naturally found in tobacco. It is the substance that produces euphoria and pleasure when inhaled as a vapor or smoked, but it’s also what makes smoking or vaping so addictive.

In addition to numerous cardiovascular, respiratory, and even neurological problems that smoking and vaping tobacco products can cause, it may also be associated with erectile dysfunction. It is believed that smoking causes problems with the lining in the blood vessels of the penis itself.

This issue, called endothelial dysfunction, can be caused by a reduction in nitric oxide and imbalances in the body that lead to oxidative stress.

Endothelial cells are responsible for the contraction and relaxation in blood vessels. To achieve an erection, vessels that supply blood to the spongy tissue and smooth muscles of the penis have to open up and allow blood to flow in. That blood then becomes trapped in the tissue of the penis.

Nitric acid prompts the muscles in the penis to relax and allow blood to flow in, and it also helps to create a seal that maintains the erection.

It Depends on the Dose

The effects of a number of substances are “dose-dependent,” meaning the larger the amount consumed, the greater the effect. Nicotine is no exception. Research shows that health problems related to smoking and vaping—including both heart disease and erectile dysfunction—are worse in heavy smokers. How much you smoke can impact how much of a problem you have with any smoking-related condition.

Cigarettes

A common source of preventable deaths, cigarette smoking is linked to nearly a half a million deaths each year in the United States alone. This fallout is from a combination of the health impact of smoking and nicotine alone, plus the effects of the thousands of other chemicals that can be found in a single cigarette.

Cigarette Smoking and Fibromyalgia

Vapes

Vaping is the second most common way to take in nicotine. One study found nearly 2.3% of tobacco users in the United States choosing this method.

The same study found that 23.1% of e-cigarette users reported never smoking, and most were younger than 35 years old. The young age of many users is concerning because nicotine is highly addictive and can negatively affect brain development, which continues until age 25.

Vaping involves using an electronic cigarette that vaporizes liquid nicotine and inhaling that vapor. While many believed that vaping is a safer method to take in nicotine, recent studies have shown a lot of significant risks.

Cigars

Cigars may have a reputation of being the classier, less dangerous version of cigarettes, but the opposite is actually true. Cigars are larger, unfiltered, more nicotine-filled versions of cigarettes that almost 4% of American smokers use.

How Does Smoking Affect Sex?

Smoking may have a negative impact on erections and overall sexual health, but for some it’s also a turn-on. Capnolagnia is a term used to describe people who become sexually aroused from watching others smoke.

The Impact of Mental Health

Getting help for erectile dysfunction can be a challenge. There are a number of mental health issues that can cause—or come with—erectile dysfunction.

One in four adults in the United States has some sort of behavioral health problem, and these individuals consume about 40% of the nation’s total cigarettes smoked. The mood-altering properties of cigarettes may make existing mental disorders seem worse too.

In addition to the mental health toll cigarettes can take, men who develop erectile dysfunction as a result of smoking may struggle with emotions like:

Shame
Depression
Inadequacy
Performance anxiety

These feelings are normal and are a primary reason that erectile dysfunction is underreported. While smoking may be used as a way to cope with stressful situations, stress and smoking may also contribute to erectile dysfunction.

If you are using smoking to deal with stress or think smoking is contributing to your erectile dysfunction, remember that smoking is a difficult addiction to overcome and that there’s help.

Additional Causes of Erectile Dysfunction

Aside from smoking, other causes of erection problems include:

Diabetes
High blood pressure
High cholesterol levels
Obesity
Certain medications

You may experience erectile dysfunction from any one—or a combination—of these conditions and medications, but your medical provider can help. A number of treatments can improve the conditions and potentially alleviate erectile dysfunction.

There are also treatments specifically for erectile dysfunction like:

Oral PDE5 inhibitors, including Viagra (sildenafil) and Cialis (tadalafil)
Penile injections, which are medications used to help you get an erection
Vacuum devices, which draw blood into the shaft of the penis and cause an erection
Surgical implants, which are inflatable implants that are surgically inserted into the penis

If you want to attempt to alleviate your erectile dysfunction naturally before trying medications, lifestyle changes like weight loss, exercise, and improving your cardiovascular health can help. Improved circulation and blood flow are key to healthy erection. Quitting smoking will also help. Researchers found that erectile dysfunction significantly improved in six months to a year after quitting smoking.

How to Maintain an Erection

There are many things you can try to improve your sexual performance and the quality of your erection. The first step is to stop worrying about it. This may be easier said than done, but stress is a major factor is erection problems.

If you are having trouble achieving or maintaining an erection, consider talking with your partner or a therapist, engaging in a relaxing activity beforehand, or using other stress management techniques.

Other things than can help strengthen your erection include:

Avoiding fatty and fried foods
Reducing your waist circumference
Getting regular exercise
Focusing on improving pelvic floor strength
Reducing stress
Involving your partner
Avoiding alcohol and other drugs
Quitting smoking

Erectile Dysfunction Doctor Discussion Guide

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Tips for Quitting

Quitting smoking is not easy. Cold turkey doesn’t work for many people, but there are a number of new programs and products designed to help you kick the habit for good.

Talk to your healthcare provider about medications like Chantix and nicotine replacement therapies. You may also find support through groups and apps or digital tools that can help you quit.

Other things that can help you quit include:

Knowing your triggers
Using all the tools available
Celebrating your milestones
Asking for help
Changing your routine and habits
Finding ways to overcome cravings

Cravings can be one of the most difficult parts about quitting smoking. Some people find relief in activities that keep their hands and mouth busy like fidget tools, gum, and candies.

Summary

Smoking can shrink blood vessels and restrict blood flow, which is an integral part of having and maintaining an erection. Some research suggests that this may be related to a reduction in nitric oxide, which helps with blood flow to the penis and keeping it there when maintaining an erection. A number of conditions can also result in erectile dysfunction, such as diabetes and high blood pressure. To help you quit smoking, you can enlist the help of your doctor, who can help you find the best nicotine replacement therapies and other strategies to quit.

A Word From Verywell

Nicotine is a highly addictive drug, but quitting can have a major impact on your overall health. If you have been experiencing erectile dysfunction or other sexual health problems and you are a smoker, finding a way to quit and stick with it may be your best bet at reducing the risk of permanent damage to your sexual health and performance. There are many tools available to help you quit.

Frequently Asked Questions

Does erectile dysfunction go away after you quit smoking?

There can be a number of contributors to erectile dysfunction, and it can be a permanent condition. However, a number of studies have shown that quitting smoking can improve the symptoms of erectile dysfunction for many.

How does nicotine affect testosterone?

Nicotine can disrupt hormone regulation, especially in the pituitary glands, resulting in a drop in testosterone levels.

How do you reverse erectile dysfunction naturally?

A healthy diet and exercise can go a long way in improving cardiovascular health and circulation, which in turn can improve the quality of your erection.

What else causes erectile dysfunction?

A number of health problems that reduce your circulation and nervous system function can contribute to erectile dysfunction. These include high blood pressure, heart disease, and diabetes.

12 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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By Rachael Zimlich, BSN, RN
Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio.

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