CORRELATION BETWEEN SMOKING AND ERECTILE DYSFUNCTION: A CROSS-SECTIONAL STUDY FROM BALOCHISTAN, PAKISTAN

Abstract

Background: Smoking is a known risk factor for erectile dysfunction (ED), yet its correlation with ED severity and duration-dependent effects remains understudied in Pakistan. This study investigated the correlation between smoking and ED among men in Balochistan, Pakistan, focusing on prevalence, severity, and the impact of smoking duration.

Methods: A cross-sectional, questionnaire-based study was conducted at Bolan Medical Complex Hospital and Doctor Hospital Quetta, from November 2024 to April 2025.  A total of 104 sexually active male participants (52 smokers and 52 non-smokers), aged 21 years or older, were included. The Sexual Health Inventory for Men (SHIM) questionnaire was used to evaluate ED. Individuals with diabetes, cardiovascular diseases, psychiatric disorders, or medication-induced ED were excluded. Data were analyzed for ED prevalence, severity (mild, mild-moderate, moderate, severe), and smoking duration. 

Results: ED prevalence was 57.7% (n=30) among smokers, compared to 17.3% (n=9) in non-smokers (p<0.001). Among smokers with ED, 60% had severe symptoms, compared to 11.1% among non-smokers. A dose-response relationship was observed: 60% of smokers with ED had smoked for over 10 years. Age-adjusted analysis confirmed smoking as an independent risk factor, with 10% of smokers aged 21–30 affected, while no ED cases were reported in non-smokers of the same age group.

Conclusion: Smoking significantly increases ED risk and severity, particularly with long-term use. The dose-dependent trend and early-onset ED among young smokers highlight smoking as an independent risk factor. Public health interventions targeting smoking cessation are urgently needed to mitigate the ED burden in Pakistan.