Association of E-Cigarettes With Erectile Dysfunction: The Population Assessment of Tobacco and Health Study

Omar El-Shahawy, Tanmik Shah, Olufunmilayo H. Obisesan, Meghan Durr, Andrew C. Stokes, Iftekhar Uddin, Ria Pinjani, Emelia J. Benjamin, Mohammadhassan Mirbolouk, Albert D. Osei, Tom Loney, Scott E. Sherman, Michael J. Blaha

Research output: Contribution to journalArticlepeer-review


Introduction: Smoking is independently associated with erectile dysfunction and cardiovascular disease. Given existing similarities in the constituents of e-cigarettes or ENDS and cigarettes, this study examines the association between ENDS use and erectile dysfunction. Methods: Data from Wave 4 (2016–2018) of the Population Assessment of Tobacco and Health study were analyzed in 2020. Male participants aged ≥20 years who responded to the erectile dysfunction question were included. Multivariable logistic regression models examined the association of ENDS use with erectile dysfunction within the full sample and in a restricted sample (adults aged 20–65 years with no previous cardiovascular disease diagnosis) while adjusting for multiple risk factors. Results: The proportion of erectile dysfunction varied from 20.7% (full sample) to 10.2% (restricted sample). The prevalence of current ENDS use within the full and restricted samples was 4.8% and 5.6%, respectively, with 2.1% and 2.5%, respectively, reporting daily use. Current daily ENDS users were more likely to report erectile dysfunction than never users in both the full (AOR=2.24, 95% CI=1.50, 3.34) and restricted (AOR=2.41, 95% CI=1.55, 3.74) samples. In the full sample, cardiovascular disease history (versus not present) and age ≥65 years (versus age 20–24 years) were associated with erectile dysfunction (AOR=1.39, 95% CI=1.10, 1.77; AOR= 17.4, 95% CI=12.15, 24.91), whereas physical activity was associated with lower odds of erectile dysfunction in both samples (AOR range=0.44−0.58). Conclusions: The use of ENDS seems to be associated with erectile dysfunction independent of age, cardiovascular disease, and other risk factors. While ENDS remain under evaluation for harm reduction and smoking-cessation potential, ENDS users should be informed about the possible association between ENDS use and erectile dysfunction.

Original languageEnglish (US)
Pages (from-to)26-38
Number of pages13
JournalAmerican journal of preventive medicine
Issue number1
StatePublished - Jan 2022

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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