Presentation Authors: Mahmoud Mima*, Sana Khan, Chicago, IL, Stephen J Freedland, Los Angeles , CA, Gerald L Andriole, St. Louis , MO, Samuel J Ohlander, Daniel M Moreira, Chicago, IL
Introduction: There is a well-established relationship between smoking and sexual dysfunction. However, the impact of smoking cessation remains unclear. We used the large data from Reduction by Dutasteride in Prostate Cancer Events (REDUCE) study to assess the association between current, former, and never smoking with sexual function.
Methods: We analyzed baseline data of 6,754 men, ages 50-75 year-old enrolled in the REDUCE study. Subjects were divided into: lifetime nonsmokers, former smokers and current smokers. Sexual function variables analyzed were: total testosterone level (nmol/L), and current sexual activity, self-reported low libido and erectile dysfunction (all yes or no). Differences in sexual function variables were assessed with chi-square test, analysis of variance and linear and logistic regressions.
Results: A total of 3,069 (45.4%) men were nonsmokers, 2,673 (39.6%) former, and 1,012 (15%) current smokers. Current smokers were significantly younger than former and nonsmokers (mean age 61.6, 63.2, 62.7 years, respectively), leaner (mean body-mass index 27.0, 27.7, 27.2 kg/m2, respectively), and had lesser prevalence of hypertension (32.4%, 41.6%, 36.8%, respectively, all P < 0.01). In univariate analysis, despite current smokers having the highest mean total testosterone levels compared to former and nonsmokers (485.4, 440.6, 451.2 nmol/L, respectively, P < 0.001), they had the highest prevalence of low libido (25.6%, 23.2%, 21.0%, respectively, P=0.002) and erectile dysfunction (31.6%, 30.3%, 26.0%, respectively, P < 0.001) with comparable sexual activity (81.7%, 80.1%, 82.8%, respectively, P=0.420). In multivariate analysis, these results were unchanged (Table).
Conclusions: Among men in the REDUCE study, current cigarette smoking was associated with worse sexual health compared to former and never smoking. Given former smokers had better erectile function and libido than current smokers, smoking cessation may improve male sexual health. This represents a large scale study supporting sexual health benefits to smoking cessation.