title: Cigarette smoking: a risk factor for erectile dysfunction in diabetics.
abstract: OBJECTIVE
  Diabetes is one of the systemic disorders most frequently associated with erectile dysfunction (ED). An extensive literature documents well the relationship between ED and several factors related to diabetic pathology, but the role of risk factors mainly related to life-style, e.g. cigarette smoking, is still not defined.
  
  
  METHODS
  Eligible for the study were men aged 20-70 years with a diagnosis of insulin-dependent (type 1---IDDM) or non-insulin-dependent (type 2--NIDDM) diabetes who were observed on randomly selected days in 178 diabetes centers in Italy. ED was defined as a failure to achieve and maintain an erection sufficient for satisfactory sexual performance.
  
  
  RESULTS
  The study population consisted of 9,670 diabetic men. Of these 2,962 (30%) were never smokers, 2,877 (30%) current smokers and 3,831 (40%) ex-smokers. After taking into account the effect of age, the odds ratios of ED in comparison with never smokers was 1.4 (95% confidence interval 1.3-1.6) for smokers and 1.5 (95% confidence interval 1.3-1.6) for ex-smokers. Duration and intensity of the smoking habit was associated with an increased risk of ED. Among ex-smokers, the risk of ED significantly decreased; with increase in the number of years since the patient quit smoking.
  
  
  CONCLUSIONS
  The study offers an assessment of the association between smoking habit and ED and its potential interaction with other risk factors in diabetic men.
authors.affiliation: Istituto Mario Negri, Milano, Italia.
authors.forename: A
authors.initials: A
authors.lastname: Bortolotti
authors.forename: D
authors.initials: D
authors.lastname: Fedele
authors.forename: L
authors.initials: L
authors.lastname: Chatenoud
authors.forename: E
authors.initials: E
authors.lastname: Colli
authors.forename: C
authors.initials: C
authors.lastname: Coscelli
authors.forename: M
authors.initials: M
authors.lastname: Landoni
authors.forename: M
authors.initials: M
authors.lastname: Lavezzari
authors.forename: F
authors.initials: F
authors.lastname: Santeusanio
authors.forename: F
authors.initials: F
authors.lastname: Parazzini
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*