At 82, Alton Ochsner, M.D., is the elder statesman of the anti-smoking movement. One of the first to link smoking with lung disease, he was ridiculed as unscientific when his book Smoking and Cancer first came out in 1954. Ove the next two decades, however, he got the best of most of his fag-puffing critics and outlived the rest. Even today, he puts in a full day's work as surgeon and senior consultant to the Ochsner Foundation Hospital in New Orleans. One thing he has noticed, after a half-century of comparing men patients who smoke with those who do not, is that abstainers have had betters sex lives and fewer cases of impotence or low sperm count than their nicotine-addicted counterparts.
Dr. Ochsner has not been the only one to notice this. In several recent studies reported in French medical journals, researchers H. Cendron and J. Vallery-Masson found that men between the ages of 25 and 40, who smoked one or more packs a day, showed a marked decline in sexual activity. Nonsmokers of the same age group showed a much smaller decline. Dr. Paul S. Larson and other researchers at the University of Virginia have reported a short-term increase in impotence among young servicemen who smoked a lot. Other studies yielded similar results. Most of these studies prove that when heavy smokers quit they get a sexual second wind.
While the connection between smoking and male sexual troubles is increasingly clear, researchers acknowledge they are not sure of the reasons. Brian Mattes, an officer of New Jersey's Smok-Enders, a highly acclaimed program to get smokers to quit, reports that the difference is one of fitness: "People who do not smoke, or those who quit, are in better shape. The oxygen level in the blood is higher, the body chemistry is free of all the accumulated poisons, and all parts of the body are in better shape, leadin to the one obvious conclusion that sex is more fulfilling. Also, people who don't smoke smell better, and this is conducive to sex."
But ther are other, more complex theories. One, from the Australian physician Dr. M.H. Briggs, is that cigarette smoking produces carbon monoxide in the blood, which in turn inhibits production of the male sex hormone, testosterone. Briggs, writing in the Medical Journal of Australia, cites a comparative study of smokers and nonsmokers matched for height, weight, marital status, etc., which showed that the testosterone levels for nonsmoking men averaged a healthy 7.47 nanograms per milliliter of blood, as opposed to 5.15 ng/ml for men who averaged a pack and a half or more a day. When the smokers abstained for only seven days, their testosterone count increased an aveage of 1.65 ng/ml, almost up to the level of nonsmokers. Additional studies show that cigarettes in combination with alcohol lead to a low testosterone level. Though a relationship between testosterone level and decreased sexual activity has yet to be proven, Briggs does say that "heavy cigarette smoking can contribute to infertility in males."
Other studies have produced even more alarming results:
- Carl Schirren, M.D. of the University of Hamburg, Germany, reports cases of "severe disturbances of sperm motility" in men who smoked one-to-two packs of cigarettes a day; he suggests smoking may explain complains of infertility.
- Tests of animals also show disturbance of sperm motility, with large amounts of nicotine leading to sterility. One study of 3,605 hamsters, reported in the medical journal Toxicology in 1973, shows nicotine leading to atrophy of the sex glands.
- Two German researchers, as reported in a German medical journal in 1974, go even further. G. Mau and P. Netter indicate that men who smoke may be endangering the lives and health of teir unborn children. This study suggests that smokers are more likely to father premature or stillborn babies than men who did not smoke. Significantly, this holds true even if the mother is a nonsmoker. The smaple of 5,200 infants also showed that children of fathers who smoked heavily had twice the normal rate of severe malformation.
Studies connection smoking with impstence, sterility and birth defects have come in for their share of criticism: some are denounced as lacking controls, relying only on questionnaires or failing to consider such factors as drinking, class and occupation. Though these dritcs admit that the evidence connecting nicotine and male dysfunction is considerable, especially in animal studies, they also claim that this evidence is inconclusive.
Ochsner has little tolerance for these criticisms, even though one, which appeared in the respected publication, Journal of Sex Research, did concede merit to some of the studies connecting smoking and male sexual performance. Although Ochsner admits that much of the data, particularly regarding testosterone levels, is inconclusive, he strongly believes that there is a need for further controlled studies to confirm the mountain of evidence already gathered.
Perhaps the most positive evidence, Ochsner says, comes from the patients he has met during his own 59 years of practice. "I really can't give any percentage estimate on the men who report improved sex lives after they stop smoking. All I can say is that I have seen literally thousands of patients who invariably tell me that they feel more energetic, healthy and alive after they quit. But many will also say, as an afterthought, that they are better off in the bedroom. And that you really don't know the difference until you quit smoking."