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Erectile dysfunction is an important smoking-related health problem. A 3-year study conducted by The University of Hong Kong Schools of Public Health and Nursing shows that over half (53.8%) of quitters reported improvement in their erectile dysfunction, indicating erectile dysfunction patients who quit smoking had a higher chance (+91.5%) to improve their erectile dysfunction problem. The study also shows that compared to simple advice, patient-centered smoking-cessation counseling with nicotine replacement therapy (NRT) is more effective in helping smokers with erectile dysfunction to quit. The results of the study are published in the latest issue of the "American Journal of Preventive Medicine".

The study provides strong evidence for a causal relationship between quitting smoking and improvement in erectile dysfunction. Professor LAM Tai-hing, Sir Robert Kotewall Professor in Public Health, Director of School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, calls for action of the government to warn the
smokers. "We recommend the government to change the current health warning that 'Smoking may cause erectile dysfunction' to 'Smoking causes erectile dysfunction'. Smokers should be aware of such adverse effect from their smoking and should quit now to prevent erectile dysfunction and other diseases caused by smoking. In fact, erectile dysfunction patients who smoke can expect some quick benefits after quitting smoking." says Professor Lam.

Professor Sophia CHAN, Professor and Head of School of Nursing, The University of Hong Kong Li Ka Shing Faculty of Medicine, highlights the effectiveness of our patient-centered smoking cessation counseling with NRT and suggests that it is necessary to plan and launch similar smoking cessation services in China and Asia, given erectile dysfunction is very prevalent in the region. "In men's health clinics and erectile dysfunction clinics, smoking cessation should be an integral part of the treatment for those clients who both smoke and have erectile dysfunction. In addition to brief advice to quit, which should be done by all health care professionals, more publicity and specialized smoking cessation services should also be provided to smokers who need such help." says Professor Chan. 

During 2001 to 2009, The Family Planning Association of Hong Kong received 4154 new patients suffered from erectile dysfunction. Over 60% of them were at the age of 30 to 50. According to Dr. Sue LO Seen-tsing, Senior Doctor, The Family Planning Association of Hong Kong, apart from psychological and physical factors such as age and diseases, smoking and alcoholism can also cause erectile dysfunction. She advises the public should
be aware of your own health and maintain healthy lifestyle, which will help to avoid sexual dysfunctions.

Research methodology:
The research team has conducted the first randomized controlled trial (RCT, which is the best study design to test the effectiveness of a treatment or intervention) to study whether smoking cessation counseling with NRT can lead to improved outcomes in smoking cessation and erectile dysfunction. During 2004 to 2007, 719 Chinese adult erectile dysfunction patients participated in the study and were randomly assigned to either intervention groups (A1 and A2) or the control group B. Intervention groups received a 15-minute face-to-face smoking cessation counseling and 1-week of free NRT at the first contact. In addition, members of group A1 received a 3-minute NRT adherence counseling session. The counseling was done by a trained male smoking cessation counselor. The control group B only received simple smoke cessation advice.

Research Findings:
Results show that 53.8% of quitters at 6-month reported improvement in their erectile dysfunction as compared with 28.1% of continued smokers. This indicated that erectile dysfunction patients who quit smoking had a higher chance (+91.5%) to improve their erectile dysfunction problem. (Note: some participants were receiving some medical treatment for erectile dysfunction during the study was conducted.)

Comparing Group A and B, those who received our smoking-cessation counseling and nicotine replacement therapy were more likely to quit (23% vs 12.8%) than those receiving simple advice on quitting. The smoking reduction rate (reduction of the number of cigarettes smoked per day by at least 50%) in the intervention groups was 42.5%, while the rate was only 28% in the control group.

About the Research Team:
The research is led by Professor LAM Tai-hing of School of Public Health and Professor Sophia Chan of School of Nursing, HKU. Their other tobacco related research covers  cardiac patients, parents of sick children, cancer survivors, youths, women and elderly populations. Researchers coming from Kwong Wah Hospital (Dr. Andrew Yip), The Family Planning Association of Hong Kong (Dr. Sue Lo and Dr. Wai-mong Kok) and School of Public Health of Boston University also contributed to the research.

This study is supported by the Research Grant Council, Hong Kong (RGC reference: HKU7428/03M) and the Hong Kong Council on Smoking and Health.