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American Journal of Epidemiology Advance Access originally published online on July 10, 2007
American Journal of Epidemiology 2007 166(7):803-809; doi:10.1093/aje/kwm154
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Cigarette Smoking and Erectile Dysfunction among Chinese Men without Clinical Vascular Disease

Jiang He1,2, Kristi Reynolds1, Jing Chen2, Chung-Shiuan Chen1, Xigui Wu3, Xiufang Duan3, Robert Reynolds4, Lydia A. Bazzano1,2, Paul K. Whelton1,2 and Dongfeng Gu3

1 Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
2 Department of Medicine, Tulane University School of Medicine, New Orleans, LA
3 Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
4 Pfizer, Inc., New York, NY

Correspondence to Dr. Jiang He, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Avenue, SL18, New Orleans, LA 70112 (e-mail: jhe{at}tulane.edu).

Received for publication November 2, 2006. Accepted for publication April 23, 2007.

The authors examined the association between cigarette smoking and risk of erectile dysfunction among 7,684 Chinese men aged 35–74 years without clinical vascular disease. Cigarette smoking and erectile dysfunction were assessed by questionnaire. Vascular risk factors were measured according to standard methods. After adjustment for age, education, alcohol consumption, physical inactivity, diabetes, hypertension, overweight, and hypercholesterolemia, the odds ratio of erectile dysfunction was 1.41 (95% confidence interval (CI): 1.09, 1.81) for cigarette smokers compared with never smokers. There was a statistically significant dose-response relation between cigarette smoking and risk of erectile dysfunction (ptrend = 0.005). Multivariate-adjusted odds ratios of erectile dysfunction were 1.27 (95% CI: 0.91, 1.77), 1.45 (95% CI: 1.08, 1.95), and 1.65 (95% CI: 1.08, 2.50) for those who smoked 1–10, 11–20, and more than 20 cigarettes per day, respectively, compared with never smokers. The association was stronger in participants with diabetes (odds ratio = 3.29, 95% CI: 1.49, 7.27) than in participants without diabetes (odds ratio = 1.33, 95% CI: 1.03, 1.73). If the association is causal, an estimated 22.7% of erectile dysfunction cases (11.8 million cases) among Chinese men are attributable to cigarette smoking. This 2000–2001 study of Chinese men documented an independent and dose-response relation between cigarette smoking and risk of erectile dysfunction.

China; impotence; men; risk factors; smoking

Abbreviations: CI, confidence interval; InterASIA, International Collaborative Study of Cardiovascular Disease in Asia


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J. He, K. Reynolds, and D. Gu
THREE OF THE AUTHORS REPLY
Am. J. Epidemiol., April 1, 2008; 167(7): 882 - 883.
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 Am J EpidemiolHome page
N. M. Gades, A. Nehra, D. J. Jacobson, M. E. McGree, J. L. St. Sauver, and S. J. Jacobsen
RE: "CIGARETTE SMOKING AND ERECTILE DYSFUNCTION AMONG CHINESE MEN WITHOUT CLINICAL VASCULAR DISEASE"
Am. J. Epidemiol., April 1, 2008; 167(7): 882 - 882.
[Full Text] [PDF]


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