title: Do cigarette smokers with erectile dysfunction benefit from stopping?: a prospective study.
abstract: OBJECTIVE
  To assess whether stopping smoking can improve erectile dysfunction (ED) in smokers, as cigarette smoking is a known risk factor for ED.
  
  
  METHODS
  Smokers who requested nicotine replacement therapy (NRT) and complained of ED were first evaluated for hypertension, dyslipidaemia, diabetes, psychiatric disorders and drug history. The grade of ED in smokers with none of these risk factors was then determined using the five-item version of the International Index of Erectile Function (IIEF-5) before NRT, and the grading repeated after 1 year of follow-up. The correlation between the exposure to smoking (pack-years) and severity of ED was assessed before the follow-up. The ED status between patients who stopped smoking after NRT and those who continued during the follow-up was then compared before and after the follow-up.
  
  
  RESULTS
  The severity of ED correlated significantly with the level of exposure to smoking. Age and ED status before the follow-up were not significantly different between 118 patients who stopped (ex-smokers) and 163 who continued smoking (current smokers). After 1 year the ED status improved in > or = 25% of ex-smokers but in none of the current smokers; 2.5% of ex-smokers and 6.8% of current smokers had a deterioration in ED. Ex-smokers had a significantly better ED status after the follow-up (P = 0.009). Among ex-smokers, patients with advanced ED and those who were older had less improvement.
  
  
  CONCLUSIONS
  There is a strong association between the intensity of cigarette smoking and degree of ED. Stopping cigarette smoking can improve ED in a considerable proportion of smokers. Age and the severity of ED before stopping are inversely related to the chance of improvement.
authors.affiliation: Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. gh_pourmand@hotmail.com
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Pourmand
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Alidaee
authors.forename: Sohrab
authors.initials: S
authors.lastname: Rasuli
authors.forename: Ameneh
authors.initials: A
authors.lastname: Maleki
authors.forename: Abdolrasoul
authors.initials: A
authors.lastname: Mehrsai
mesh_terms: D000328:Adult; D007172:Erectile Dysfunction / Q000209:etiology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation