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SAN ANTONIO -- Most men who smoke cigarettes are very aware that the habit increases their risk for lung cancer, chronic obstructive pulmonary disease (COPD), and heart disease.

But a small study suggests they are largely unaware of another smoking-related risk, one that hits below the belt, Khushbir Bath, MD, of Harlem Hospital in New York City, reported here.

When clinicians at Bath's hospital asked over 100 men (current or former smokers) if they knew that smoking is a risk factor for erectile dysfunction, fewer than one in seven said they did.

The finding, if confirmed in larger studies, suggests that anti-tobacco public health messaging may be missing an opportunity to motivate men to kick the habit, Bath told 名媛直播.

The study was presented at CHEST 2018, the annual meeting of the American College of Chest Physicians.

"If more men knew that smoking for 20 or 30 years increases their risk of having difficulty achieving an erection, that could be a strong motivator for quitting," he said. "Maybe even more of a motivator for some men than telling them, 'You are going to die.'"

Bath said he got the idea for the study after having a conversation with a patient in his 40s who said he was having difficulty with erections. The man, who was a heavy smoker, said he wasn't aware the habit could contribute to erectile dysfunction.

"He knew that smoking caused lung cancer, heart disease, and mouth cancer. He even knew that it caused infertility in women, but he didn't know that it caused difficulty with erections," Bath said. "When I told him he looked at me and said, 'I'm going to quit right now.'"

Bath said the informal study included 104 men (>18 years) who smoked or were former smokers being treated at his Harlem Hospital primary care clinic who volunteered to take the survey.

Questionnaires collected data on demographics, general health status, smoking history, past medical history, and knowledge regarding smoking and its health hazards.

The majority of the respondents were African American (57%), and 23% were Hispanic.

Most of the participants were current smokers (96%). Of those, 39% had smoked for over 20 years, 45% reported smoking more than a pack per day, and 97% reported that the main hazard of smoking is lung cancer, while 47% reported heart disease as likely to be related to smoking.

Only 14 responders (13%) knew about the association between smoking and erectile dysfunction.

All respondents said having adequate knowledge of the association between smoking and all three of these health conditions would be a motivator for them to quit smoking.

Bath said that when he conducted an informal investigation, including an internet search, to examine cigarette package labeling and anti-tobacco messaging in the U.S., he found no mention of erectile dysfunction as a smoking-related risk.

In contrast, he found that cigarette package labeling in 26 countries outside the U.S. included impotence warnings.

Bath said countless studies over the past 20 years have proven the link between chronic cigarette smoking and impotence. He added that he would like to see a larger study done to confirm his findings.

"From my small study it does appear that people in my community lack this knowledge," he said. "Primary care physicians should be telling their male patients who smoke about this risk."

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