Smoking contributes to atherosclerosis by aggravating risk factors leading to build-up of plaque in the walls of blood vessels, causing blockages and restricting blood flow. Penile blood vessels are particularly susceptible because of their small size.

In particular smoking increases atherosclerosis because it elevates levels of:

  • Cholesterol: The toxins in tobacco smoke lower a person’s high density lipoprotein cholesterol (HDL or “good” cholesterol) while raising levels of low-density lipoprotein cholesterol (LDL or “bad” cholesterol).
  • Nicotine and Carbon Monoxide: The nicotine and carbon monoxide in cigarette smoke damage the cells in blood vessel walls, which sets the stage for the build-up of plaque.
  • High Blood Pressure: While cigarette smoking won’t cause high blood pressure, if a smoker has hypertension, smoking can increase the risk of malignant hypertension, a dangerous form of high blood pressure. Smoking is hard on the heart.

For more details see Smoking and Erectile Dysfunction.