Background
Epidemiological studies show that chronic smokers are about 1.5 to 2 times more likely than non-smokers to report erectile dysfunction (ED), after controlling for age and cardiovascular risk factors.
It follows that smoking cessation may enhance erectile function but this has not been adequately tested in men with varying levels of erectile function, and using a subjective as well as physiological measures of sexual function.
Aim
The study aimed to provide the first empirical investigation of the association between smoking cessation and indices of physiological and subjective sexual health in men, irrespective of erectile function status.
Methods
Male smokers, irrespective of erectile dysfunction status, who were motivated to stop smoking (‘quitters’), were enrolled in an 8-week smoking cessation programme involving a nicotine transdermal patch treatment and adjunctive counselling based on the tobacco use and dependence clinical practice guidelines.
Participants were assessed at baseline (while smoking regularly), at mid-treatment (while using a high-dose nicotine transdermal patch), and at a 4-week post nicotine patch cessation follow-up.
Physiological (circumferential change via penile plethysmography) and subjective sexual arousal indices (continuous self-report), as well as self-reported sexual functioning (measured with the IIEF) were assessed at each visit.
Data were analysed using general linear modelling (Analysis of covariance) to compare successful with unsuccessful quitters at each time point for each outcome variable.
Results
Analyses (described by the authors as ‘intent-to-treat analysis’) indicated that, at follow-up, successful quitters (n= 20), compared with those who relapsed (n= 45), showed enhanced erectile tumescence responses, and faster onset to reach maximum subjective sexual arousal.
Although successful quitters displayed across-session enhancements in sexual function, they did not show a differential improvement compared with unsuccessful quitters.
Both groups showed a reduction in the proportion with ED (defined by the IIEF) from baseline to follow-up with no significant difference between groups.
Conclusion
Smoking cessation significantly enhances both physiological and self-reported indices of sexual health in long-term male smokers, irrespective of baseline erectile impairment. However a lower prevalence of ED was not found in successful quitters compared to unsuccessful quitters.
The authors hope that these results may serve as a novel means to motivate men to stop smoking.
