Erectile Dysfunction (ED) and Cardiovascular Disease (CVD) have long been linked to smoking. However, few studies have looked into whether men who use Electronic Nicotine Delivery Systems (ENDS), sometimes known as e-cigarettes, have the same link.

Researchers from NYU Grossman School of Medicine and Johns Hopkins University School of Medicine published a study online today in the American Journal of Preventive Medicine that suggests men between the ages of 20 and 65 who use ENDS daily and have no prior history of CVD are more than twice (2.4 times) as likely to report erectile dysfunction as men who have never used ENDS.

According to the researchers, since ENDS consumption appears to be linked to ED regardless of age, CVD, or other prevalent ED risk factors, ENDS users should be educated about the possible relationship between ENDS use and ED, which affects one in every five males in the United States over the age of 20.

“Our analyses accounted for the cigarette smoking history of participants, including those who were never cigarette smokers to begin with, so it is possible that daily e-cigarette vaping may be associated with higher odds of erectile dysfunction regardless of one’s smoking history,” says Omar El Shahawy, the lead author of the study.

The study relied on data from the Population Assessment of Tobacco and Health (PATH) Survey, a nationally representative study of 45,971 individuals in the United States aged 18 and above that looked at various tobacco use behaviors and health consequences.

The participants in this study were 13,711 males aged 20 and up who answered a question about ED. Dr. Tanmik Shah, lead statistician and study co-author from NYU Langone, looked at the link between ENDS and ED in the entire sample as well as a subset of 11,207 adult males aged 20 to 65 with no prior CVD diagnosis, while controlling for a variety of risk variables. Never, former, and current (occasional or daily) users were assigned to respondents. Almost half of the individuals had previously smoked cigarettes, 21 percent were currently smoking cigarettes, and 14 percent used other tobacco products.

The study found that daily users were more than twice as likely to report experiencing ED as individuals who had never used ENDS (2.2 times in the full sample and 2.4 times in the restricted sample). There was a substantial link between ENDS usage and ED among respondents aged 20 to 65 with a normal BMI and no CVD, implying that ED and ENDS use are linked in a generally healthy group.

In the small sample, 10.2 percent of respondents said they had ED. Only 5 percent said they used ENDS on a regular basis, while 2.5 percent said they used them every day. In both the entire and limited samples, current daily ENDS users were more likely to report ED than those who said they had never used ENDS. In both demographic groups, physical activity was linked to a decreased risk of ED.

As per researchers, one study limitation is that the analysis relied on self-reported data on ENDS use and ED status, all of which are susceptible to misclassification and desirability bias. Another limitation is that the analyses were conducted on a small sample size (the possibility that respondents will answer questions based on what they think will be perceived favorably by others). There was also no information provided about whether or not the respondents were taking any medications that were associated with ED, such as antidepressants or beta blockers, which would have been helpful.

According to El Shahawy, the next phase of the research will focus on determining whether some types of ENDS are more strongly associated with ED than others, and whether reported ED may be reversible by quitting their usage. Due to the fact that this study only looked at men, future research should look into the relationship between ENDS use and dysfunction in women.

Source: American Journal of Preventive Medicine

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