Smoking and Sex

By Lisa Moreno-Walton, MD, MS, MSCR, FAAEM, FACEP, FIFEM

Professor of Emergency Medicine, Director of Research, Director of Diversity- LSU School of Medicine

Imagine the Harlem Renaissance:  Black beauties in slinky gowns and Marcel curls holding slim cigarette holders; handsome dudes in Zoot suits pulling smokes from gold cases.  Fast forward to modern movies of couples between the sheets, enjoying an after sex smoke.  Even John Legend talks about post-coital smoking in the “The Best You Ever Had”. But listen, smoking is actually not sexy. 

I’m not going to waste time talking about the nasty breath and the stink on your clothes and hair.  Some people actually like the smell, or don’t mind it.  What I am going to tell you is that sex, done well, not only feels exquisite, but constitutes a moderate workout.  It increases the blood pressure and the heart rate.  Good sex usually ends with sweaty bodies and some panting going on, and this means that we have exercised well.  Good exercise results in an increased oxygen demand on the body and increased work of the heart. 

Smoking actually robs the body of oxygen and replaces it with carbon monoxide, which is a poison that in high enough doses, leads to death.  When carbon monoxide replaces oxygen on the red blood cells, these cells cannot deliver the oxygen that the heart needs to engage in physical exertion, and the person has to stop what he is doing and rest.  We all know smokers or former smokers who cannot climb a full set of stairs or walk quickly down 4-5 city blocks without having to stop.  These same people have to stop in the middle of vigorous sex!  Not fun. 

Smoking also causes changes in the blood vessels that are farther from the heart.  This is called peripheral vascular disease (PVD), and it affects the blood vessels in the legs and the hands.  It causes numbness, tingling, and a dusky color that indicates that there is not an adequate supply of blood being delivered to the region. The blood vessels in the pelvis that go down into the legs deliver the blood supply to the penis and vagina.  PVD affects these blood vessels.  When a man is sexually aroused, the penis fills with blood and valves at the base of the penis close off so that the blood stays in the penis, resulting in an erection and the feeling of heat and pressure.  Smoking results in damaged blood vessels and a poor blood supply to the penis, which can cause impotence, a partial erection or the inability to maintain an erection.

While women’s performance lack is not as evident as men’s are, smoking can result in decreased swelling of the vaginal tissue, so the vagina is not as “tight”.  In this situation, the pressure and friction necessary for the male partner’s pleasure and orgasm is lacking.  This situation, combined with the decreased vaginal and clitoral sensation resulting from smoking, interferes with women’s sexual pleasure and orgasm as well.  If you want the intense pleasure of sex and the natural high of vigorous sexual activity, never start smoking, or stop smoking if you have started.

Quitting is hard.  Vaping is NOT a solution (more about vaping in a future column).  Your doctor can help.  We offer behavior modification, nicotine patches to wean you off your nicotine addiction, and pills that can relieve your cravings and the depression that can sometimes accompany smoking cessation.  Smoking not only causes high blood pressure, damage to your heart, increased risk of stroke, and poor circulation, it robs you of the joy of sex!  Don’t start smoking.  It is not sexy!  If you do smoke, the best chance of quitting is with medical supervision.  See your doctor today, and start on the path to GREAT SEX!