• Omar El-Shahawy, Tanmik Shah, Olufunmilayo H Obisesan, Meghan Durr, Andrew C Stokes, Iftekhar Uddin, Ria Pinjani, Emelia J Benjamin, Mohammadhassan Mirbolouk, Albert D Osei, Tom Loney, Scott E Sherman, and Michael J Blaha.
• Department of Population Health, New York University Grossman School of Medicine, New York, New York; Global and Environmental Health Program, NYU School of Global Public Health, New York, New York; The Ciccarone Center for the Prevention of Cardiovascular Disease, John Hopkins Medicine, Baltimore, Maryland. Electronic address: omar.elshahawy@nyulangone.org.
• Am J Prev Med. 2022 Jan 1; 62 (1): 263826-38.

IntroductionSmoking is independently associated with erectile dysfunction and cardiovascular disease. Given existing similarities in the constituents of e-cigarettes or ENDS and cigarettes, this study examines the association between ENDS use and erectile dysfunction.MethodsData from Wave 4 (2016-2018) of the Population Assessment of Tobacco and Health study were analyzed in 2020. Male participants aged ≥20 years who responded to the erectile dysfunction question were included. Multivariable logistic regression models examined the association of ENDS use with erectile dysfunction within the full sample and in a restricted sample (adults aged 20-65 years with no previous cardiovascular disease diagnosis) while adjusting for multiple risk factors.ResultsThe proportion of erectile dysfunction varied from 20.7% (full sample) to 10.2% (restricted sample). The prevalence of current ENDS use within the full and restricted samples was 4.8% and 5.6%, respectively, with 2.1% and 2.5%, respectively, reporting daily use. Current daily ENDS users were more likely to report erectile dysfunction than never users in both the full (AOR=2.24, 95% CI=1.50, 3.34) and restricted (AOR=2.41, 95% CI=1.55, 3.74) samples. In the full sample, cardiovascular disease history (versus not present) and age ≥65 years (versus age 20-24 years) were associated with erectile dysfunction (AOR=1.39, 95% CI=1.10, 1.77; AOR= 17.4, 95% CI=12.15, 24.91), whereas physical activity was associated with lower odds of erectile dysfunction in both samples (AOR range=0.44-0.58).ConclusionsThe use of ENDS seems to be associated with erectile dysfunction independent of age, cardiovascular disease, and other risk factors. While ENDS remain under evaluation for harm reduction and smoking-cessation potential, ENDS users should be informed about the possible association between ENDS use and erectile dysfunction.Copyright © 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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