Association of Quantity and Duration of Smoking with Erectile Dysfunction: A Dose–Response Meta-Analysis

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IntroductionSome original studies and a recent meta-analysis suggested that smoking could be associated with the risk of erectile dysfunction (ED), but the dose–response relationship between them was unclear.AimThe aim of this study was to investigate the potential association between quantity and duration of smoking and the risk of ED.MethodsWe conducted a literature search of PubMed, Embase, Web of Science, and Scopus from these databases' inception through March 2014 for observational epidemiological studies examining the association between smoking and risk of ED. Random-effects meta-analyses were used to combine the results of included studies.Main Outcome MeasureQuantitative review of published observational epidemiological studies on the association between smoking and risk of ED was the main outcome measure.ResultsOne cohort study and nine cross-sectional studies were eligible for inclusion in the meta-analysis (50,360 participants and 12,218 cases with ED). No evidence of a curve linear association was observed between smoking and risk of ED. The summary odds ratio of ED for an increase of 10 cigarettes smoked per day was 1.14 (95% confidence interval 1.09 to 1.18), with moderate heterogeneity (P = 0.061, I2 = 44.7%). For an increment of 10 years of smoking, the combined odds ratios of ED was 1.15 (95% confidence interval 1.10 to 1.19), without substantial heterogeneity (P = 0.522, I2 = 0.0%).ConclusionsEvidence from observational studies suggests that there is a positive dose–response association between quantity and duration of smoking and risk of ED. Cao S, Gan Y, Dong X, Liu J, and Lu Z. Association of quantity and duration of smoking with erectile dysfunction: A dose–response meta-analysis. J Sex Med 2014;11:2376–2384.

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