Does nicotine increase testosterone or quietly wreck it?
Dr. Alexander Grant, MD, PhD: Urologist & Men's Health Advocate
Nov 20, 2025 · 10 min read
In observational studies, male cigarette smokers average about 15% higher total testosterone and 13% higher free testosterone than non-smokers, likely because nicotine alters liver hormone metabolism and slows testosterone breakdown. That “smoker’s paradox” can still coincide with erectile dysfunction and infertility as smoking damages blood vessels and testosterone-producing Leydig cells, so higher lab numbers don’t ...