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Can Smoking and Vaping Cause Erectile Dysfunction?

9 min read time

Written by: Sunny Dhain

Medically reviewed by: Jennifer Kaur

Published 19/12/2025 Updated 12/10/2026

Key takeaways

Smoking clearly raises the risk of erectile dysfunction, and vaping probably does too
Nicotine is the common culprit because it restricts blood flow
Quitting often improves erections, sometimes quickly
Support is available for both quitting smoking and ED

Yes, smoking is a well-known cause of erectile dysfunction (ED), and there’s growing evidence that vaping raises the risk too. Both usually involve nicotine, which tightens blood vessels and cuts the blood flow an erection needs.

Most of the conversation about smoking and vaping focuses on the heart and lungs, but the same damage to your circulation can affect your sexual health and sex life.

Does smoking and vaping cause erectile dysfunction?

The link with smoking is well established. For vaping, it’s newer and less certain, but it points in the same direction.

Smoking and ED

A 2013 review combined studies of more than 28,000 men. Men who smoked were around 50% more likely to develop ED than non-smokers. Men who had quit still carried some extra risk, but less than those who kept smoking.

How much you smoke matters too. In one study of younger men, those who smoked more than 20 cigarettes a day were twice as likely to have severe ED as lighter smokers.

Vaping and ED

The biggest study so far comes from the US Population Assessment of Tobacco and Health (PATH) study. Men who vaped every day were more than twice as likely to report ED as men who had never vaped. The link remained even when researchers looked only at men aged 20 to 65 with no history of heart disease.

Many of the vapers were also current or former smokers, which may explain some of the risk. And vapes haven’t been around long enough for anyone to study their effects over decades.

Is vaping safer than smoking?

If you smoke, switching completely to vaping is far less harmful than carrying on, which is why the NHS recommends vaping as a way for adult smokers to quit. Vapes aren’t meant for people who have never smoked, and using both gives you the risks of each without the benefits of quitting.

How do smoking and vaping affect erections?

An erection comes down to blood flow. When you’re aroused, nerves in the penis release nitric oxide, a chemical that relaxes the blood vessels so blood can rush in and stay there. Nicotine interferes with this at several points.

In the short term, it tightens your blood vessels. Nicotine triggers a release of adrenaline, which narrows the arteries and pushes up your heart rate and blood pressure, so less blood reaches the penis. This happens within minutes, which is why smoking or vaping just before sex can make an erection weaker.

Over months and years, the effects build up. Nicotine and other inhaled chemicals damage the lining of your blood vessels, where nitric oxide is made, so the arteries can’t open properly. That damage also encourages fatty plaque to build up inside the arteries. The arteries supplying the penis are much narrower than those supplying the heart, so they often show problems first. This is why ED can be an early warning sign of heart disease.

Why cigarettes do more damage

Smoke contains carbon monoxide, which reduces how much oxygen your blood can carry, along with other chemicals that inflame blood vessels and speed up arterial hardening. That’s why there’s strong evidence against smoking.

Vapes don’t burn anything, so there’s no carbon monoxide or tar. They do contain flavourings, propylene glycol and vegetable glycerine, and some lab studies suggest these may irritate blood vessels, but there’s little research into this.

Does smoking and vaping affect testosterone and libido?

In smokers, nicotine has been shown to interfere with the hormones that tell the testes to make testosterone. Research into vaping is limited because it’s mostly tested in animals.

A 2023 review of e-cigarettes and reproductive health found that rats exposed to vape liquid had lower testosterone and damaged testicular tissue.

Libido isn’t only about hormones, either. Poor sleep, stress and low mood, which often come with nicotine dependence, can dampen your sex drive.

If a low sex drive comes with tiredness, low mood or loss of muscle, ask your GP about a testosterone blood test. And if you’re trying for a baby, it’s worth knowing that smoking lowers sperm quality.

Does quitting smoking or vaping help ED?

For many men, yes. Most of the research is in smokers, but since nicotine is the common thread, the same is likely to apply to vaping.

A 2004 study in BJU International followed men with ED who used nicotine replacement therapy to stop smoking. A year later, at least a quarter of those who had quit had better erections, while none of those who kept smoking had improved.

A 2012 study of long-term smokers found that men who stayed away from smoking had noticeably stronger erections within 8 weeks, compared with those who went back to smoking.

You’re likely to see the biggest difference if you’re younger, haven’t smoked or vaped for long, and your ED is mild. After many years of heavy smoking, some of the damage may not reverse, but stopping smoking keeps ED from getting worse.

How long after quitting does ED improve?

Everyone is different, but this gives you a rough idea of what to expect:

Time after stopping	What changes
20 minutes	Your heart rate and blood pressure start to settle as the nicotine wears off
24 to 36 hours	In heavy smokers, blood flow in the penis can already start to improve
2 to 12 weeks	Circulation gets better, and many men notice stronger erections by around 8 weeks
6 to 12 months	The biggest improvements in erectile function are usually seen by now
1 year and beyond	Your risk of heart disease drops to about half that of a smoker

For more information, we have a handy guide on what to expect in the first 4 to 12 weeks of quitting smoking.

Don’t be put off if things feel worse at first. Nicotine withdrawal can affect your mood, sleep and sex drive for a few weeks, but this usually settles within a month. If you don’t improve after a few months, speak to a pharmacist or your GP.

Can nicotine patches, gum or lozenges cause ED?

Possibly because they still contain nicotine. In a 2008 trial published in the Journal of Sexual Medicine, a single piece of nicotine gum reduced the erectile response of healthy men who didn’t smoke. That’s no reason to avoid nicotine replacement therapy (NRT), though.

NRT is meant to be used for a limited time, usually 8 to 12 weeks, with the dose stepped down as you go. It gives you less nicotine than smoking, at a steadier level, and none of the smoke. Any effect on your erections should fade as you cut down and stop.

If you’d rather avoid nicotine altogether, prescription tablets such as varenicline, Zyban and cytisine are nicotine-free. Our pharmacists can help you choose the option that suits you.

Treatment for ED and help to stop smoking

At The Family Chemist, you can get help with both quitting and ED through a confidential online consultation.

Help to stop smoking or vaping

With expert support and stop smoking aids, you’re up to three times more likely to quit than with willpower alone. Depending on what suits you, that might be:

nicotine replacement therapy – patches, gum, lozenges, inhalators or mouth sprays

nicotine-free prescription tablets – varenicline, Zyban or cytisine

Your local NHS Stop Smoking Service also offers free support.

Treatment for erectile dysfunction

While you’re quitting smoking, or if your erections don’t fully recover, ED tablets can help. Medicines such as sildenafil (Viagra) and tadalafil (Cialis) work by improving blood flow to the penis when you’re sexually aroused. They’re effective for most men and can generally be used alongside NRT.

Complete an online consultation, and our clinicians will ensure that the treatment is suitable for you.

When to see your GP

See your GP if your ED keeps coming back, especially if you also have chest pain, shortness of breath, diabetes or high blood pressure. The NHS advises getting persistent erection problems checked, as they can be linked to other health conditions.

Conclusion

Smoking and vaping can both play a part in erectile dysfunction, but smoking carries the bigger risk. Whichever you use, nicotine affects the blood flow that erections rely on. Stopping is the most useful thing you can do, and for many men, erections improve within weeks to months. If you’d like support with quitting or with ED, our clinical team is here to help.

FAQS

Does smoking or vaping make your penis smaller?

Yes, it can, when blood flow is reduced, erections are less firm, so the penis can look smaller when erect. Over years, damage to the blood vessels and tissue in the penis could reduce erect length. Better circulation after quitting can help erections become firmer again.

Can smoking or vaping cause ED in young men?

It can. Smoking is one of the main reasons men under 40 develop ED, and heavy smokers in their 20s and 30s are more likely to have severe ED than lighter smokers. The PATH study also found a link between daily vaping and ED in men aged 20 to 65 who had no history of heart disease.

Is ED from smoking or vaping permanent?

Usually not. Many of nicotine’s effects on blood flow wear off once you stop, and erections often improve within weeks to months. Men who have smoked heavily for many years, or who have severe ED, may see less change, but treatment can still help.

Is vaping or smoking worse for erections?

Smoking is worse. Cigarettes expose you to far more harmful chemicals as well as nicotine, and there’s no evidence that vaping is worse. If you smoke, switching completely to vaping is better for your health, but stopping nicotine altogether is best.

How we reviewed this article:

Smoking and risk of erectile dysfunction: systematic review of observational studies with meta-analysis. (2013) PLOS ONE. Cao et al. [Accessed 5 October 2026]
Association of e-cigarettes with erectile dysfunction: the Population Assessment of Tobacco and Health Study. (2022) American Journal of Preventive Medicine. El-Shahawy et al. [Accessed 5 October 2026]
Do cigarette smokers with erectile dysfunction benefit from stopping? A prospective study. (2004) BJU International. Pourmand et al. [Accessed 5 October 2026]

Current version
12th Oct 2026 Edited by: Sunny Dhain, MPharmRS PGDip IndP
5th Oct 2026 Medically reviewed by: Jennifer Kaur, MRpharmS

Medically reviewed by:

Jennifer Kaur MRpharmS

I began my journey as a pharmacist, over 15 years ago, as a community pharmacist and have since progressed through various types of management to eventually land into the online pharmacy world.

Last reviewed: 5th Oct 2026

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Can Smoking and Vaping Cause Erectile Dysfunction?

Key takeaways