Vaping nicotine is less terrible than smoking for your health, but it’s not without its own potentially harmful health consequences — including a rather intimate aspect of male well-being.

What’s new — In a recent study published in the American Journal of Preventative Medicine, researchers reveal daily nicotine vapers are more than twice as likely to report having erectile dysfunction as people who never used e-cigarettes.

Erectile dysfunction is one of the myriad health problems caused by smoking. Cigarette chemicals damage blood vessels, affecting blood flow — and you need good blood flow to sustain an erection. Because nicotine and other additives are also in e-cigarettes, Omar El-Shahawy, Assistant Professor at NYU’s Grossman School of Medicine and lead researcher on the study, and his colleagues wanted to know if the relationship between e-cigarette use and ED would be similarly strong.

This study detects a similar effect results from vaping nicotine for what El-Shahawy and his colleagues say is the first time.

How they did it — The researchers used data from the Population Assessment of Tobacco and Health (PATH) Study, a national longitudinal representative study looking at tobacco use behaviors and health outcomes.

“[W]e have been studying health effects of smoking for five decades and e-cig[arettes are] relatively new. Our team wanted to look at a comprehensive picture regarding potential health effects and we were pleased to find that this was assessed on a national level,” El-Shahway tells Inverse.

Out of 45,971 survey respondents, the researchers focused on two groups of respondents:

1. Full sample: A full sample of 13,711 males aged 20 and older who had answered a survey question about erectile dysfunction
2. Subset: A restricted sample of 11,207 males aged 20 to 65 years with no prior cardiovascular disease diagnosis

The men were then classified as never, former, and current — occasional or daily — nicotine users. Former cigarette smokers made up 53 percent of the respondents, 21 percent were current cigarette smokers, and 14 percent used other tobacco products.

In total, 4.8 percent of all the men in the study said they currently use electronic nicotine delivery devices (vapes), although the proportion was slightly higher among the men in the subset. In the full sample, 2.1 percent of men vaped nicotine daily; men in the subset showed a higher propensity to daily use, at 2.5 percent reporting daily vaping.

All the men were asked this question:

Many men experience problems with sexual intercourse. How would you describe your ability to get and keep an erection adequate for satisfactory intercourse? Would you say that you are…

Respondents could then choose a response:

• Always able to get and keep an erection
• Usually able to get and keep an erection
• Sometimes able to get and keep an erection
• Never able to get and keep an erection

Men who picked “sometimes” or “rarely” were then classified as having moderate to severe erectile dysfunction. Finally, the researchers matched up the men with erectile dysfunction to their vaping habits to see if there was a relationship between the two.

What they found — The results were not ideal for vapers who want their neither regions in tiptop shape. Compared to those who never vaped, daily users were more than twice as likely to report having erectile dysfunction — this was particularly true for the men in the restricted sample: 2.2 times as likely for the full sample, and 2.4 times as likely for the subset.

In the subset, 10.2 percent of respondents reported having erectile dysfunction to some degree. Of these men, 5.5 percent were occasional vapers; 2.5 percent were daily users.

El-Shahawy says this was not unexpected.

“Nicotine is nicotine in any form — the theory is that e-cigarettes can deliver high nicotine levels perhaps — at least some of them do,” he explains.

What’s next — There may be some salve for committed vapers, however, and men in general: Among everyone in this study, taking physical activity was associated with a lower rate of erectile dysfunction.

It is unknown whether the link between erectile dysfunction and e-cigarette use is as strong as it is between cigarettes, El-Shahawy says.

“This is the first study [looking at the connection between e-cigarettes and erectile dysfunction] and we can’t quantify the risk based on one study. Also, more comprehensive analysis with other measures for [erectile dysfunction] assessment is needed,” he adds.

El-Shahawy wants to study whether e-cigarette use also affects female sexual health. He also hopes to look at longer-term patterns linking erectile dysfunction and e-cigarette use.

Ultimately, it makes sense that vaping nicotine would have some of the same effects as smoking nicotine on the body. That said, it’s important to underscore the fact that, from a health perspective, e-cigarettes are not as bad as traditional cigarettes, especially if used in moderation.

“Overall health effects from using e-cigarettes are significantly less than smoking, but at the same time [they] should not be used excessively,” El-Shahawy concludes.

Abstract:

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=0.440.58).

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.