Does Smoking (or Vaping) Lower Testosterone?

Medically reviewed by: Katelyn Schwartz, NP, Family Nurse Practitioner with Advanced Training in TRT, BHRT, and Menopause Care
Last reviewed: October 2026

You light up after a long day, or reach for the vape on the drive home, and a thought nags at you. Lately you feel flatter, your drive is lower, and the gym feels harder than it should. So does smoking lower testosterone, and is that what you’re feeling? The research gives a surprising answer, and it changes what you should test for.

Here’s the twist. Smokers often show slightly higher testosterone on a blood test, not lower. But that number hides a lot, and other parts of male sexual health tend to get worse.

Does Smoking Lower Testosterone? The Short Answer

Usually not, at least on a standard blood test. Large studies find that men who smoke tend to have slightly higher total testosterone than non-smokers. Yet smokers are more likely to have lower sperm counts and erection problems, and men over 40 who smoke report more symptoms of low testosterone. A normal number doesn’t mean smoking is harmless to your sexual and reproductive health.

So the honest answer is “not the way most people think.” If you feel tired, low or uninterested in sex, those symptoms deserve a proper workup whether you smoke or not. Men in British Columbia can start that conversation through TRT in Vancouver with a licensed Nurse Practitioner.

What the Short Answer Leaves Out

Most of the research is observational, so it shows links, not cause and effect.
Many studies measured only total testosterone, which can mislead in smokers.
Very heavy nicotine exposure may flip the pattern downward.
Vaping, snus and nicotine gum have far less research behind them, and the findings don’t all agree.

Why Men Who Smoke Often Test Higher

Most men assume the answer to “does smoking decrease testosterone?” is an easy yes. Yet the opposite finding keeps turning up. A 2016 meta-analysis in Preventive Medicine pooled 22 studies covering 13,317 men. On average, smokers had testosterone about 1.53 nmol/L higher than non-smokers. That’s a modest gap, and the authors noted that cotinine, a substance the body makes from nicotine, slows the breakdown of testosterone.

What the Largest Recent Studies Found

A 2024 analysis in Scientific Reports looked at 7,797 American men from a national health survey. It measured cotinine in the blood, which tracks real tobacco exposure better than asking people how much they smoke. Higher cotinine went with higher total testosterone, up to a point. Above about 487 ng/mL of cotinine, a high level, testosterone started falling again.

In Denmark, a 2020 study in Human Reproduction tested 2,008 young men with a median age of 19. Daily smokers had 6.2% higher total testosterone and 6.2% higher free testosterone than non-smokers. Free testosterone is the portion not tied up by carrier proteins, so the rise wasn’t only a lab quirk.

Total Testosterone vs. Free Testosterone

Most of your testosterone travels bound to proteins, mainly sex hormone-binding globulin (SHBG) and albumin. A standard test reports the total, bound and unbound together. When SHBG shifts, total testosterone can move without much change in what your tissues actually use. One small Czech study found SHBG dropped after men quit, so smoking may push it up, though other factors could explain the change. That’s why a full workup matters more than one figure. Our guide to the difference between total testosterone and free testosterone explains how the two are read together.

Coffee shows a similar pattern. In a large Harvard cohort, men who drank four or more cups a day had slightly higher total testosterone, and coffee drinkers tended to have more SHBG, as our guide to coffee and testosterone explains.

Higher Numbers, More Symptoms

For men over 40, one study stands out. Researchers in China surveyed 6,296 men aged 40 to 79 and published their results in Aging in 2021. Smokers had higher total testosterone in every age group except the oldest. Still, current and former smokers reported more sexual and physical symptoms of low testosterone at every age from 40 to 79.

So if you’re asking does smoking lower testosterone, the better question may be what it does to the rest of you. In this study, the lab result and the lived experience pulled in opposite directions. In older age groups, the link between smoking and higher testosterone weakened, while the link with low-testosterone symptoms grew stronger.

Smoking and Testosterone Studies at a Glance

The table below sums up the main hormone studies. Each row is cigarette smoking compared with not smoking, unless the row says otherwise.

Study	Who took part	Testosterone in smokers	What else was found
Zhao et al., 2016	22 studies, 13,317 men	About 1.53 nmol/L higher on average	Observational data only
Holmboe et al., 2020	2,008 Danish men, median age 19	Total and free both 6.2% higher in daily smokers	Lower total sperm count in daily smokers
Liu Q et al., 2021	6,296 Chinese men aged 40 to 79	Higher in most age groups	More low-testosterone symptoms at every age
Liu M et al., 2024	7,797 American men	Rose with cotinine, then fell at very high levels	Turning point near 487 ng/mL cotinine

Does Vaping Lower Testosterone?

Current human research hasn’t shown that vaping lowers testosterone, and the largest study found no significant difference either way. In a large Danish study of young men, testosterone wasn’t higher in vapers as it was in smokers, yet daily vapers had lower sperm counts. Lab research shows e-cigarette aerosol can disrupt the cells that make testosterone, so the long-term answer is still open.

That’s a cautious answer, and it needs to be. Vaping is newer than smoking, and nobody has followed vapers’ hormones over years. What exists so far are snapshots.

What Lab Research Suggests

A 2026 review in Molecular and Cellular Endocrinology pulled together animal, cell and human studies. In lab models, e-cigarette aerosol and its ingredients consistently harmed Leydig cells, the testicular cells that make testosterone. The suspected routes include oxidative stress, inflammation and damage to the cell’s energy machinery.

But the same review found the human evidence thin and inconsistent. All of it comes from one-time snapshots of different people, and the largest showed no testosterone difference. So the risk is biologically plausible, and it isn’t proven in people yet.

Sperm and Erections Tell a Different Story

The Danish study shows the split clearly. Testosterone wasn’t higher in e-cigarette users, unlike in smokers. Daily vapers, though, had a total sperm count of 91 million, against 147 million in non-users. The authors noted that daily vapers were few, so the finding needs repeating.

Erections raise a similar flag. A 2022 American study in the American Journal of Preventive Medicine found that daily e-cigarette users had about 2.2 times the odds of reporting erectile dysfunction compared with men who had never vaped. In a subgroup aged 20 to 65 with no prior cardiovascular disease, the figure was about 2.4. That study captured one point in time, so it can’t show that vaping causes the problem.

Nicotine Without Smoke: Snus, Pouches and Gum

If smoke were the only problem, smoke-free nicotine would be a clean swap. The research doesn’t fully support that.

Snus and Oral Tobacco

A Swedish study of 613 men, published in Andrology in 2022, compared 109 snus users with non-users. Snus users had 24% lower total sperm counts and 14% higher testosterone, even after accounting for cigarette smoking. More boxes per week went with bigger hormone shifts. The authors estimated that this could mean about a 10% lower chance of fathering a child.

Still, the picture isn’t settled. The Danish study found no link between snuff and testicular function at all. Two studies disagree, which tells you the oral nicotine question is still open. Nicotine pouches are newer still, and there’s very little hormone data on them.

Nicotine Gum

In a small 2022 crossover study from Taiwan, published in the International Journal of Environmental Research and Public Health, 13 non-smoking baseball players chewed nicotine gum or placebo gum before testing. Salivary testosterone dipped after the nicotine gum, then returned to baseline once the tests were done. Thirteen young men and a few hours of data can’t tell you much about long-term hormones. The dip also wasn’t statistically different from the placebo gum, so it’s at most a hint that nicotine affects hormones in the short term.

Where Smoking Does Its Real Damage

Testosterone is only one part of male reproductive health. The other parts are where smoking shows up most clearly.

Sperm Quality

A 2016 meta-analysis in European Urology combined 20 studies of 5,865 men. Smoking went with lower sperm counts, poorer movement and fewer normally shaped sperm. Most men studied were attending fertility or urology clinics, and the effect was larger in infertile men and in moderate and heavy smokers. For a man hoping to start or grow a family, these numbers matter more than a testosterone reading. If fertility is part of your plans, our page on TRT and fertility covers what to discuss before any hormone treatment.

Erections and Blood Flow

An erection depends on blood vessels that can widen fast. A 2015 systematic review in European Urology Focus concluded that smoking is strongly linked with erectile dysfunction. The main suspects are damage to the lining of blood vessels, less nitric oxide and more oxidative stress. Secondhand smoke, especially over years, may also play a part.

This is why a smoker can have a normal testosterone level and still struggle in bed. The hormone signal arrives, but the plumbing can’t respond the way it should. Our article on the role of testosterone in erectile dysfunction explains where hormones fit and where they don’t.

Does Quitting Smoking Increase Testosterone?

Probably not by much, and that’s fine. The benefits of quitting show up elsewhere.

What Happens to Your Hormone Numbers

In a Czech study of 76 male smokers, published in Physiological Research, 26 stayed smoke-free for a full year. Their SHBG fell significantly, from a median of 26.2 to 20 nmol/L. Total testosterone dipped slightly, from 12.5 to 11.1 nmol/L, but that change wasn’t significant. They also put on some weight over the year.

So don’t expect a testosterone boost from stopping. A slightly lower total reading after quitting may reflect lower SHBG, though the weight these men gained could also play a part.

What Happens to Erections

Here the news is better. A 2020 study in the International Brazilian Journal of Urology followed men aged 30 to 60 through a smoking cessation clinic. Six months after quitting, their erectile function scores were higher in every age group. The gain held in most smoking-history groups, and only the very heaviest smokers fell short of statistical significance.

The 2015 European Urology Focus review reached the same conclusion: quitting may ease the damage smoking does to erections.

Is Vaping a Good Way to Quit?

Health Canada says that switching completely to vaping is less harmful than continuing to smoke. It also says vaping isn’t harmless, can cause nicotine dependence, and has long-term risks that are still unknown. If you vape to quit, the goal is to stop smoking fully, then step down from nicotine over time. Using both together keeps the smoke exposure going.

Getting an Accurate Testosterone Test if You Smoke or Vape

Does smoking lower testosterone on paper? Usually the reverse, so a single test can paint a misleadingly normal picture. Testing well matters more for smokers, not less.

Book two early-morning tests. The Endocrine Society says diagnosis should rest on at least two early-morning, fasting testosterone tests.
Aim for the morning window. Canadian guidance published in CMAJ recommends drawing blood between 7 and 11 am.
Ask for more than total testosterone. Free testosterone, SHBG and LH together give a clearer read than one number.
Tell your provider about all nicotine use. Cigarettes, vapes, snus, pouches and gum all count.
Consider a semen analysis. If fertility is the worry, it answers the question a hormone test can’t.

Our guide on how to test testosterone levels accurately walks through the steps in more detail.

When Low Testosterone Is Real: Options for Men Who Smoke or Vape

Sometimes the tests do come back low. The Endocrine Society notes that low energy, low libido and low mood are common in aging men and have many causes. It also asks providers to rule out reversible contributors first, such as excess weight and certain medications. For men whose low testosterone is tied to excess weight, it calls weight loss the usual first step. You can read more on the connection between obesity and low testosterone, and on medically supported weight loss.

Lifestyle Factors That Stack Up

Smoking rarely acts alone. Alcohol, poor sleep and ongoing stress all weigh on hormones too, and they often travel together. Our articles on how alcohol affects testosterone levels and on stress and testosterone cover those links. Age adds its own gradual decline, explained in why testosterone decreases with age.

Where TRT Fits

When two tests confirm a deficiency and symptoms match, testosterone replacement therapy may be an option. It starts with bloodwork, and it needs regular monitoring by a licensed provider. It isn’t right for everyone. As the StatPearls physiology reference from the US National Library of Medicine explains, outside testosterone can switch off the brain signals that drive sperm production. Men planning a family need a different conversation. The Endocrine Society also notes that long-term safety, including for the prostate, isn’t fully established.

Treating a confirmed deficiency doesn’t remove the reasons to quit smoking, and both are worth discussing together. If you’re unsure who to see, our article on who can help with low testosterone lays out your options, and our overview of common symptoms of low testosterone can help you describe what you’re feeling.

Smoking, Vaping and Testosterone: Common Questions

Q: Does nicotine itself raise or lower testosterone?

Nobody knows yet. Studies of smokers link higher cotinine with slightly higher total testosterone up to a point, but young men who vaped or used snuff in a large Danish study showed no such rise. In one small trial, salivary testosterone dipped after nicotine gum and then recovered, but the change wasn’t significantly different from placebo gum. None of this suggests nicotine is good for your hormones.

Q: Does smoking lower testosterone more in older men?

Not on the blood test. In a study of 6,296 men aged 40 to 79, the testosterone gap in smokers shrank with age and vanished in the oldest group. Their symptoms, though, were worse than non-smokers’ at every age.

Q: Will my testosterone go up if I quit smoking?

Probably not much. In one study of men who quit for a year, total testosterone didn’t change significantly, while SHBG fell. The clearer gain from quitting shows up in erections, along with the well-known benefits for your heart and lungs.

Q: How soon after quitting might erections improve?

In one study of men aged 30 to 60, erectile function scores improved within six months of quitting. In that study, the gain fell just short of significance only in men with the very heaviest smoking histories.

Q: Should I mention smoking or vaping before a testosterone test?

Yes. Smoking can nudge total testosterone up, so your provider needs that context to read the result. Two early-morning, fasting tests on separate days give a more reliable picture than one.

Q: Does smoking affect fertility even if my testosterone looks normal?

Yes, it can. Pooled data link smoking with lower sperm counts, poorer sperm movement and more abnormal shapes. A semen analysis tells you far more about fertility than a testosterone level.

The Bottom Line on Smoking and Testosterone

Does smoking lower testosterone? On a blood test, usually not, and it often reads a little high. Vaping doesn’t seem to move the number much either. Neither one helps you. Both are linked with lower sperm counts and more erection trouble, and smoking goes with more low-testosterone symptoms as men age.

If you feel off, focus on the full picture rather than one figure. Quitting smoking and getting properly tested are practical first steps. When you’re ready to find out where your levels really stand, you can book a consultation with Beyoung Health’s clinical team.

This content is for informational purposes only and does not constitute medical advice. Consult a qualified healthcare provider before starting any treatment.