This study is interesting and doubtless it is well regarded generally and I'm sure it contains lots of useful findings, not being a Doctor I can't say for sure. But I have several problems with it, firstly it's extremely old, a lot of science has passed under the bridge since 1986, and advances in our knowledge regarding genetics and a whole raft of other things has greatly increased since then. Secondly the study group is impaired by being self sellected, being as it only covers men who attended an impotence clinic, and not a more generalised group and in terms of medical studies the group was relatively small it's also a bit hazy on the study parameters.
Here are some newer studies for you:
Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study -- Levy 2 (4): 278 -- The British Journal of Diabetes & Vascular Disease (see table 1)
SMOKING AND ERECTILE DYSFUNCTION: EVIDENCE BASED ANALYSIS
Cigarette smoking and other vascular risk factors ...[Urology. 1991] - PubMed Result
Look I'm definitely not disputing that smoking can have a huge range of very serious and in many cases fatal side effects, and I wouldn't recommend anyone take it up for these reasons, and would support anyone I knew in giving it up.
However there has been a tendency to almost randomly attribute a variety of illnesses and ailments to smoking as a default position when smoking was the only common factor a particular study was able to find in a studied group. The problem with this is a laziness in studying, many studies don't bother to be rigorous enough to look for other more subtle factors or if other common factors do exist they are often discounted in favour of the theory that smoking is the primary factor.
I understand the logic, smoking is incredibly bad for you, and doctors want to dissuade people from smoking by any means they can. I just think they could do so perfectly well by using the evidence we know to be solid, it's terrifying enough. Because what will happen is that instead of doctors discovering the true causes for problems they have rashly attributed to smoking and working to cure them all the focus will be on smoking.
This happened to me, I have an inherited skin condition, Hydradenitis Superativa, which because my doctor said was linked to smoking, I gave up for 18 months as a result but with no improvement in the condition and I was not properly treated for a long time. When I finally found out that other members of my family also suffered with this problem I told my doctor who was compelled to change the treatment of the condition, which is now thankfully under control, despite my having taken up smoking again, I have since discovered that the evidence that this condition is linked to smoking is highly speculative indeed and should not have formed the basis for a treatment plan.
I'm sorry to hear about your condition
I'm also one not to take something at face value just because it's an MD saying so. That's why I do lots of research- it's part of what I do for a living.
All of the studies I've read on impotence and non-organic causes all point to smoking having negative short and long term effects on penile health. In the more detailed studies they show that there's always more than one factor contributed by smoking that does this.
For the heavy smokers among us, if you can perform adequately while smoking several packs a day, picture what your health and performance would be like if you didn't smoke. I'm sure most of you will agree that there'll be some improvement.