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Smoking and Erectile Dysfunction - Surgeon General’s Report

Erectile dysfunction (ED) has been added to the list of medical conditions caused by smoking, according to a report released last month by the U.S. acting surgeon general.

How does smoking lead to ED? To answer this question, it’s helpful to understand how a man gets an erection.

When a man is sexually stimulated, messages are transmitted through the nervous system from his brain to his penis. As a result, the arteries in his penis widen to allow more blood to flow in. Once the penis is erect, veins constrict to keep the blood inside. After the man ejaculates, the veins open again and the blood flows back into the body.

Blood flow is critical for a firm erection. If there is a problem with blood flow, the man will have a weak erection or he might not have an erection at all.

Smoking can cause atherosclerosis – hardening of the arteries. When this happens, plaques accumulate on the arterial walls, making it more difficult for blood to flow through. When atherosclerosis occurs in penile arteries, it can interfere with erections.

Smoking can also cause other health problems linked to ED, such heart disease and diabetes. Both conditions can lead to atherosclerosis.

In addition, nerve damage (neuropathy) from diabetes can impair the transmission of messages from the brain to the penis. And high blood sugar can reduce the production of certain chemicals needed to create an erection.

Rheumatoid arthritis is another smoking-related illness than can affect erectile function.

Many men’s sex lives are affected by anxiety and depression as well. While these problems may not be linked directly to smoking, they are common among patients who have serious health conditions related to smoking, such as cancer, asthma, vision problems, and impaired immunity. Living with a chronic health problem can take its toll physically, emotionally, psychologically, and – in turn – sexually.

For more details on the surgeon general’s report, please click here.

Print this article or view it as a PDF file here: Smoking and ED - Surgeon General’s Report


U.S. Department of Health and Human Services

“The Health Consequences of Smoking—50 Years of Progress. A Report of the Surgeon General - Executive Summary”

(January 2014)

“Let’s Make the Next Generation Tobacco-Free: Your Guide to the 50th Anniversary Surgeon General’s Report on Smoking and Health”

(January 2014)

National Heart, Lung, and Blood Institute

“How Does Smoking Affect the Heart and Blood Vessels?”

(December 20, 2011)

The New York Times

Tavernise, Sabrina

“List of Smoking-Related Illnesses Grows Significantly in U.S. Report”

(January 17, 2014)

Sexual Medicine Society of North America

“Diabetes – Erectile Dysfunction”

“ED and Heart Trouble”

The Washington Post

Dennis, Brady

“Surgeon general report links more diseases, health problems to smoking tobacco”

(January 17, 2014)