E-cigarette Use Tied to Erectile Dysfunction

By Megan Brooks

December 13, 2021

NEW YORK (Reuters Health) - Use of electronic cigarettes may raise the risk of erectile dysfunction (ED) independent of age, cardiovascular disease (CVD) and other risk factors, a new study suggests.

"Overall, e-cigarette are likely less harmful than smoking cigarettes to the degree that they substitute cigarette smoking," lead author Dr. Omar El Shahawy of NYU Grossman School of Medicine, in New York City, told Reuters Health by email.

However, "we need to properly inform the public that using any tobacco or nicotine product is not risk free, especially for those who are thinking of starting to use it. For men who smoke and want to switch because vaping is less harmful, they should try to limit their vaping because it is simply not risk free," Dr. El Shahawy said.

The new findings stem from the Population Assessment of Tobacco and Health (PATH) study, a nationally representative study of nearly 46,000 U.S. adults that examines various tobacco-use behaviors and health outcomes.

The researchers analyzed two PATH samples: a full sample made up of 13,711 men aged 20 and older and an age-restricted sample of 11,207 men aged 20 to 65 years who were free of cardiovascular disease (CVD).

The proportion of men with ED varied from 20.7% in the full sample to 10.2% in the restricted sample.

The prevalence of current e-cigarette use within the full and restricted samples was 4.8% and 5.6%, respectively, with 2.1% and 2.5%, respectively, reporting daily use, Dr. El Shahawy and his colleagues report in the American Journal of Preventive Medicine paper.

Current daily e-cigarette users were significantly more likely to report ED than never-users in both the full sample (adjusted odds ratio, 2.24) and the restricted sample (aOR, 2.41).

In the full sample, the presence CVD history and age 65 years and older (vs age 20 to 24 years) were both significantly associated with ED (aOR, 1.39 and aOR, 17.4, respectively). Physical activity was associated with lower odds of ED in both samples.

"This is the first study looking at the relationship between using e-cigarettes and erectile dysfunction so we need to do more research to be able to fully contextualize this possible relationship," Dr. El Shahawy told Reuters Health.

"For example, what level of e-cigarette use can impact normal erectile function? Is there a dose-response relationship between both? At this point, we simply don't know enough, whether this maybe only due to the nicotine in e-cigarettes or there could be other components in the e-liquid that can potentially impact erectile function," he said.

The researchers caution that the study was based on self-reported data on e-cigarette use and ED status, which are subject to misclassification and desirability bias (the possibility that respondents will answer questions based on what they think will be perceived favorably by others). They also lacked data on whether or not the respondents were taking any medications associated with ED such as antidepressants or beta-blockers.

SOURCE: https://bit.ly/3Iqup55 American Journal of Preventive Medicine, online November 30, 2021.