Does nicotine increase testosterone or quietly wreck it?

Some studies say nicotine nudges testosterone up. Others say it does nothing. All agree on one thing: the tradeoffs for your health and hormones are steep.

The relationship

Search “does nicotine increase testosterone” and you will see people claiming that smoking is a secret hack for higher T. That idea comes mainly from a few observational studies that linked cigarette smoking with slightly higher testosterone levels in men compared with nonsmokers.

In one widely cited study from 2001, male smokers showed about 15 percent higher total testosterone and 13 percent higher free testosterone than men who had never smoked. A later review in 2015 came to a similar conclusion: across several studies, smokers often had a modestly higher testosterone level than nonsmokers. The increase tended to track with how many cigarettes men smoked per day.

But here is the catch. Those testosterone numbers were still in the normal range for both smokers and nonsmokers. And follow-up analyses show that the difference in testosterone is unlikely to be large enough to change how you feel in the real world. Energy, sex drive, muscle mass, and mood are driven by far more than a small bump in T, especially when that bump is paired with nicotine’s well-documented harms.

How it works

To understand why the question “does nicotine increase testosterone” is so confusing, you have to look at how nicotine interacts with the hormone system that runs from your brain to your testicles.

Nicotine and the brain–testicle axis

The hypothalamic–pituitary–gonadal axis is the chain of signals from your brain to your testes that controls testosterone production. It starts in the hypothalamus, a deep brain region that releases gonadotropin-releasing hormone, or GnRH, which tells the pituitary gland to release two key messengers: luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH then tells the Leydig cells in your testes to make testosterone.

Nicotine is a stimulant that binds to nicotinic acetylcholine receptors in the brain. Short term, this can increase activity in the hypothalamus and change the release of GnRH and other hormones. Some human studies show that smokers have slightly higher LH levels, which could explain a small rise in testosterone. Animal experiments have also shown both stimulation and suppression of this axis depending on dose and duration of nicotine exposure.

Short-term stress hormones and T

Cortisol is a stress hormone made by your adrenal glands that can affect testosterone. Smoking and nicotine use trigger a stress response in your body, which causes a quick increase in adrenaline and cortisol. Some studies find that in the short term this stress surge can come with a small bump in circulating testosterone, possibly because the body is activating several hormone systems at once.

Over the long term, though, chronically elevated cortisol is linked with lower testosterone and poorer overall hormone balance. Men with chronic stress or high cortisol often have lower total and free testosterone levels, and they are more likely to report low libido, fatigue, and reduced muscle mass.

Sex hormone–binding globulin and “usable” testosterone

Sex hormone–binding globulin, or SHBG, is a protein in your blood that binds to testosterone and other sex hormones. When testosterone is bound to SHBG, it is not readily available for tissues. Doctors often look at free testosterone, which is the small fraction not tightly bound to SHBG, as a better reflection of hormone action in the body.

Some research suggests that smoking can alter SHBG levels. When SHBG shifts, total testosterone on your lab report may change even if free testosterone — the part that matters most for symptoms — barely moves. In the 2001 study, both total and free testosterone were somewhat higher in smokers, but the absolute difference was small and remained within a normal range for almost all men.

Body composition, metabolism, and measured testosterone

Body fat percentage can influence testosterone levels. More visceral fat — fat around your abdomen and organs — is linked with lower testosterone because fat tissue converts testosterone into estrogen using an enzyme called aromatase. Smokers often weigh less on average than nonsmokers, and smoking can blunt appetite and change metabolism, at least temporarily.

This difference in body composition may partly explain why some studies find slightly higher testosterone in smokers. It may not be nicotine directly “boosting” testosterone but the way smoking shifts weight and fat distribution. At the same time, smoking increases the risk of diabetes and metabolic syndrome, which are both linked with lower testosterone and erectile dysfunction over time.

Thresholds that actually matter for symptoms

Meta-analyses show that men with clear symptoms of low testosterone and total testosterone below about 350 nanograms per deciliter are the ones most likely to benefit from testosterone replacement therapy. When total testosterone is borderline, doctors check free testosterone. Levels below about 100 picograms per milliliter support a diagnosis of hypogonadism, which means the testes are not making enough testosterone.

In the smoking studies, both smokers and nonsmokers usually land between roughly 400 and 600 nanograms per deciliter. That means even when smoking nudged numbers up, most men were already above the treatment threshold. This is a key reason urologists do not recommend nicotine as any sort of testosterone strategy.

Conditions linked to it

When you look beyond the narrow question of “does nicotine increase testosterone,” a bigger picture comes into focus: nicotine and smoking raise the risk of several conditions that directly damage men’s hormone and sexual health.

First, smoking is a major risk factor for erectile dysfunction. Large population studies show that male smokers have a significantly higher risk of ED than nonsmokers, even after adjusting for age and other factors. The main reason is blood vessel damage. Nicotine and other chemicals in smoke injure the endothelium, the thin cell layer lining your arteries, which reduces blood flow to the penis.

Second, smoking impairs fertility. Sperm from male smokers are more likely to have lower counts, poorer motility — meaning they swim less effectively — and more DNA damage. Even if testosterone is not drastically lower, damaged sperm and testicular tissue make it harder to conceive. These effects show up not only with cigarettes but also with other forms of nicotine exposure at high dose.

Third, nicotine and smoking significantly raise the risk of metabolic and cardiovascular problems. Men who smoke have higher rates of heart disease, stroke, and diabetes. All three are linked with lower testosterone levels, lower sex drive, and more fatigue in the long run. As these conditions develop, any small early bump in testosterone from nicotine can be wiped out or reversed.

Finally, chronic nicotine use is tangled up with mental health. Men with heavy nicotine dependence have higher rates of anxiety and depression. Low mood, poor sleep, and stress can independently suppress testosterone and make symptoms of low T much more noticeable, even if lab numbers are only mildly reduced.

Because most of the research on nicotine and testosterone comes from observational studies, there are limitations. It is hard to fully separate the effect of nicotine itself from other lifestyle factors like diet, alcohol, exercise, and socioeconomic status. Modern nicotine products such as vapes and pouches may not have identical effects to traditional cigarettes, and they have not been studied as deeply in relation to testosterone.

Symptoms and signals

Even if you are mostly interested in “does nicotine increase testosterone,” what truly matters is how you feel and function. These are key signs to watch for if you use nicotine and are worried about your hormones or sexual health:

• Lower sex drive or less interest in intimacy than before
• Weaker erections, trouble getting or keeping an erection, or needing more stimulation to stay hard
• Reduced morning erections compared with your usual pattern
• Feeling more tired during the day, especially in the afternoon, even with decent sleep
• Loss of muscle mass or strength despite consistent training
• Increase in belly fat or overall weight gain, especially after years of nicotine use
• Slower recovery from workouts and more frequent minor injuries
• Mood changes such as irritability, low motivation, or feeling “flat”
• Trouble concentrating or staying focused, especially between nicotine doses
• Fertility concerns, like trouble conceiving or abnormal semen analysis
• Symptoms of vascular problems, such as calf pain with walking or a history of heart disease or stroke

These symptoms do not prove you have low testosterone, and they do not prove nicotine is the cause. But they are all reasons to step back and look at your hormone profile, your nicotine habits, and the rest of your lifestyle together.

What to do about it

Instead of chasing quick fixes or believing message-board claims about “does nicotine increase testosterone,” use a simple, science-based plan: test, improve, and monitor.

1. Get objective testing and a real baseline. If you use nicotine and have symptoms that might relate to low testosterone, ask your doctor for morning bloodwork between 7 and 10 a.m. This should include total testosterone, free testosterone, SHBG, and often LH, FSH, and prolactin. Men with persistent symptoms and total testosterone below about 350 nanograms per deciliter, or free testosterone below about 100 picograms per milliliter, are the ones who typically benefit from treatment. Repeat testing on a different day to confirm low levels.
2. Address nicotine and core lifestyle levers first. Talk with your clinician about quitting or reducing nicotine. Evidence-based options include nicotine replacement, prescription medications, and behavioral coaching. At the same time, build habits that naturally support healthy testosterone: resistance training two to four days per week, prioritizing 7 to 9 hours of sleep, limiting heavy evening alcohol use, and aiming for a lean but sustainable body composition with plenty of whole foods and adequate protein.
3. Consider medical treatment when needed, then monitor regularly. If your levels are clearly low and symptoms are significant even after improving lifestyle and addressing nicotine, a urologist or endocrinologist may discuss testosterone replacement therapy. Ongoing monitoring should include testosterone levels, blood counts, prostate health, and cardiovascular risk markers. For men quitting nicotine, rechecking testosterone and erectile function several months later can also be motivating, because many see rebounds in both.

Myth vs Fact

• Myth: Smoking is a cheap way to raise testosterone.
  Fact: Any increase in testosterone from smoking is small, usually keeps you within the normal range anyway, and comes packaged with higher risks of erectile dysfunction, heart disease, and infertility.
• Myth: If you vape instead of smoke, nicotine will still boost your T safely.
  Fact: We do not have long-term data showing vaping improves testosterone or is harmless for male hormones. Nicotine itself is addictive and can still affect blood vessels, sleep, and stress systems that influence testosterone.
• Myth: Higher testosterone from smoking always means better sex and more muscle.
  Fact: Sexual performance and muscle growth depend on many factors. Vascular damage, lung capacity loss, and fatigue from smoking can easily outweigh a tiny hormone bump.
• Myth: If my testosterone labs are normal, my nicotine use is not hurting my hormones.
  Fact: Nicotine can harm erections, sperm quality, and cardiovascular health even when testosterone levels look normal on bloodwork.
• Myth: Quitting nicotine will tank my testosterone and make me feel worse forever.
  Fact: Some men feel off in the first weeks of quitting, but over months, better sleep, better lung function, and improved blood flow often support stronger libido, erections, and more stable testosterone.

Bottom line

The honest answer to “does nicotine increase testosterone” is this: some studies find that male smokers have slightly higher testosterone levels than nonsmokers, but the difference is small, often driven by body composition differences, and almost never big enough to change symptoms. At the same time, nicotine and smoking clearly increase the risk of erectile dysfunction, infertility, cardiovascular disease, and metabolic problems that can crush your hormone health over time. If you care about testosterone, the smart move is not to use nicotine as a shortcut but to quit it, lock in the basics of sleep, training, nutrition, and stress, and work with a specialist if your levels remain low.