Association of Poly-tobacco Use with Erectile Dysfunction: Findings from the Population Assessment of Tobacco and Health (PATH) Study

Abstract

ABSTRACT Introduction The tobacco use landscape has shifted over time to include two or more tobacco products (i.e. "poly-tobacco" use). Tobacco smoking remains independently associated with erectile dysfunction (ED); however, data on the patterns of multiple tobacco products use on men's sexual health, including ED, are limited. Objective We sought to systematically evaluate the effects of poly-tobacco use on ED using nationally representative data. Methods Data from the Population Assessment of Tobacco and Health (PATH) survey wave 4 (December 2016- January 2018) was examined. Those who responded, “sometimes or never” to the question “Ability to get and keep an erection adequate for satisfactory intercourse?” were classified as having ED. Tobacco users were classified as mono-, poly- and non- users based on the past 30-day tobacco products use. Multivariate logistic regression models were used to identify association of tobacco use with ED among a restricted sample that included only men aged 20-65 who did not report any prior cardiovascular diagnosis. We adjusted for several covariates including sociodemographic characteristics, diabetes, body mass index, mental health status, and physical exercise. Results Included in the study were adult males, aged 20-65 years or older, who responded to the question assessing ED between December 2016 to January 2018 (N=8,651). Among the study population, 19.5% participants were mono-tobacco users and 16.1% were poly-tobacco users. The proportion of ED for the sample population was 8.2%; prevalence among mono-tobacco users was 1.7% and poly-tobacco users was 1.4%. Compared to non-users, current poly-tobacco users were more likely (adjusted OR (aOR)= 1.43; 95% CI=0.99, 2.07;p<0.05) to report having ED. Conclusions With the shift in the landscape of tobacco products that is associated with increasing prevalence of poly-tobacco products use, adult men and clinicians should be aware of its potential impact. Future studies should evaluate the longitudinal effect of multiple tobacco and tobacco use trajectories on the development of ED among adult men. Disclosure No