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Study links e-cigarette use to erectile dysfunction

Q: Our teenage son's vaping habit has his mother and me quite worried about his health. Nothing we've said so far has had any impact. I recently read vaping can cause erectile dysfunction in young men. Is that true? If so, we may have finally found a persuasive argument for him to stop.

A: Although electronic cigarettes were initially developed to help smokers quit, manufacturers quickly developed hundreds of products aimed directly at the youth market.

Nicotine-based e-cigarettes come in a wide array of candy and fruit flavors. Many of them deliver amped-up forms of nicotine beyond what traditional cigarettes contain. Their allure is reflected in the latest National Youth Tobacco Survey, which found that more than 2 million middle and high school students are regular e-cigarette users. Unfortunately, the explosive growth of these products has outpaced their regulation and oversight, which leaves most of their ingredients a mystery.

Nicotine itself is a highly addictive chemical. It can raise blood pressure, increase heart rate, suppress insulin production and promote the buildup of plaque in the artery walls. Propylene glycol, which is one of the delivery agents in e-cigarettes, is used in the manufacture of solvents, antifreeze and the artificial smoke in fog machines.

E-cigarettes are still relatively new, so facts about the short- and long-term health effects of inhaling the chemicals they contain are just beginning to emerge. This includes research that links inhaling the heated tobacco vapor of an e-cigarette to increased risk of developing asthma and chronic obstructive pulmonary disease. And now, as you've mentioned in your letter, a new study has tied vaping to erectile dysfunction, or ED.

According to researchers at New York University, the use of e-cigarettes doubled the risk of ED in men age 20 and older. The findings, published last fall in the American Journal of Preventive Medicine, were based on two years of data collected in a federally funded study into smoking habits and health outcomes in the U.S.

Of the 13,700 men who answered a question about ED, those who used e-cigarettes every day were more than twice as likely to experience erectile dysfunction as were those who had never vaped.

Previous studies have drawn a strong connection between both smoking and nicotine to ED. This is due to the effects of nicotine, as well as the thousands of chemicals present in cigarette smoke, on the vascular system. However, the higher likelihood of ED in the regular vapers was a surprise. So was the lower end of the age range. Studies in rats have linked the chemicals in e-cigarette liquids with low sperm count and low testosterone in men, which may be playing a role.

While the severe lung injuries that were in the news a few years ago were linked to black market cannabis products, nicotine-based e-cigarettes are far from harmless. Persuading a teen to change his habits already is hard enough without a highly addictive substance in the mix. We hope the new information about the link to erectile dysfunction will help you make your point.

• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu.

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