Original Contribution Cigarette Smoking and Erectile Dysfunction among Chinese Men without Clinical Vascular Disease

The authors examined the association between cigarette smoking and risk of erectile dysfunction among 7,684 Chinese men aged 35–74 years without clinical vascular disease. Cigarette smoking and erectile dysfunction were assessed by questionnaire. Vascular risk factors were measured according to standard methods. After adjustment for age, education, alcohol consumption, physical inactivity, diabetes, hypertension, overweight, and hypercholesterolemia, the odds ratio of erectile dysfunction was 1.41 (95% confidence interval (CI): 1.09, 1.81) for cigarette smokers compared with never smokers. There was a statistically significant dose-response relation between cigarette smoking and risk of erectile dysfunction (ptrend 1⁄4 0.005). Multivariate-adjusted odds ratios of erectile dysfunction were 1.27 (95% CI: 0.91, 1.77), 1.45 (95% CI: 1.08, 1.95), and 1.65 (95% CI: 1.08, 2.50) for those who smoked 1–10, 11–20, and more than 20 cigarettes per day, respectively, compared with never smokers. The association was stronger in participants with diabetes (odds ratio 1⁄4 3.29, 95% CI: 1.49, 7.27) than in participants without diabetes (odds ratio1⁄4 1.33, 95% CI: 1.03, 1.73). If the association is causal, an estimated 22.7% of erectile dysfunction cases (11.8 million cases) among Chinese men are attributable to cigarette smoking. This 2000–2001 study of Chinese men documented an independent and dose-response relation between cigarette smoking and risk of erectile dysfunction.