Dear Dr. G,

I have been following your articles for a while now and have always been fascinated by your approach in addressing sexual health issues.

I have read your previous articles on ED (Erectile Dysfunction) and I understand you previously highlighted the risk of ED in men is higher if they live a sedentary lifestyle; smoking with a high-cholesterol diet, high blood pressure and a lack of exercise.

Although I accept that an unhealthy lifestyle MAY contribute towards the wilting “pride and joy” of men, I am not 100% convinced that tobacco truly has such a detrimental impact on a man’s organ.

I have been a smoker for at least 20 years and I am aware that there has been a movement to encourage men to stop smoking in our society at large. I also think the personal choice of smokers should be respected.

In view of the upcoming World No Tobacco Day, I would like to put Dr. G on the spot, and scrutinize the true “damage” cigarette may have on a man’s sexual organ.

Is there evidence correlating smoking with the severity of ED?

I also would like to know whether stopping smoking can improve the sexual function of men affected by ED associated with smoking.

Don’t get me wrong, I am a smoker with a fully-functioning manhood. However, I can only give up my lifetime addictive pleasure if I can be convinced of the facts.

Thanking you in advance.


Erectile Dysfunction (ED) is well-defined as the recurrent or consistent inability to obtain and maintain an erection for sexual performance. With the incidence of ED increasing with age, affecting up to 40% of men at the age of 60 and nearly 100% of men in their 80’s, various risk factors such as hypertension, high levels of lipids in the blood, diabetes and obesity have been associated with a flaccid manhood.

Smoking is one of the world’s greatest threats to public health and has been postulated to be a cause of ED in some epidemiological studies. However, the true extent of smoking affecting erectile function and its mechanism remains unclear and widely debated.

A recent study examined the quantity and duration of smoking in 50,360 participants and found that 12,218 men were affected by ED. Further analysis demonstrated that if a man smoked 10 cigarettes a day, he increased his risk of ED by 14%. The same study also found that if a man was a smoker for ten years, his erectile function would deteriorate by another 15%.

Another Canadian study also supported the fact that men with ED were twice as likely to be current or former smokers, and cumulative smoking also result in a dose-dependent pattern of ED risk.
Considerable scientific data also shows that smoking-related ED is most likely due to the damage of the blood vessel lining, a process called endothelia. Other research has demonstrated the reduction of nitric oxide availability, causing organ stress in the reduction of the oxygenation to the poor penis. Yes, you can mention the world “penis” in this column. It is a sexual health column, after all!

A few centres investigated the effect of quitting smoking on the recovery of erectile functions. One study revealed the recovery of nocturnal erections within 24 hours of cessation despite 30 pack-years of smoking. However, concrete conclusions about recovery are difficult to establish as such studies only observed small numbers of participants with a short follow-up.

Indeed, WNTD (World No Tobacco Day) is observed around the world on the 31st of May. This is intended to encourage 24-hour abstinence from all forms of tobacco consumption to create a positive impact on the nearly six million associated deaths worldwide. Although the focus this year by WHO is “Tobacco and Heart disease”, for the purpose of the potential wilting willy of William, we should also focus on the negative impact of “Tobacco and Hard disease”!

My favorite British Contemporary Artist, Damien Hirst, who famously explored the complex relationship between art, religion, life and death once said: “Smoking is a perfect way to commit suicide without actually dying”. When Dr. G is put on the spot to persuade a man to stop smoking for the sake of preserving the rigidity of his pride and joy, his comment is often: “Smoking is a perfect way to ensure a Wilting Willy, missing the Penile function is as good as committing suicide without dying!” On that note, I wish Willy (I mean William) and the smokers worldwide a successful World No Tobacco Day!


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