By Dr. Diana Rangaves, PharmD

Does Nicotine Increase Testosterone? What the Research Really Says

Nicotine has long been associated with a range of health concerns - but lately, there’s been increasing curiosity about its impact on testosterone. Some online sources and anecdotal reports suggest that nicotine might increase testosterone levels, especially in men. But does science support this claim?

Let’s explore what the latest research reveals about the connection between nicotine use and testosterone, including the effects of cigarettes, nicotine pouches, and vaping.

How Testosterone Works in the Male Body

Testosterone is a vital hormone that supports a variety of male physiological functions including muscle mass, bone density, libido, sperm production, and mood regulation. Produced primarily in the testes by Leydig cells, testosterone secretion is regulated by a complex system known as the hypothalamic–pituitary–gonadal (HPG) axis.

When evaluating whether nicotine affects testosterone levels, researchers often look at serum testosterone (the measurable level of testosterone in blood) and its downstream effects, such as sperm count and fertility.

Can Nicotine Raise Testosterone Levels?

Some studies have suggested a potential association between nicotine use and elevated testosterone levels in men. For instance, one cross-sectional study observed that male smokers had slightly higher total testosterone levels than non-smokers. This finding has fueled speculation that nicotine may stimulate testosterone production.

However, these results must be interpreted with caution. In many of these studies, confounding factors - such as lower body mass index (BMI) among smokers or the acute stress response caused by nicotine - could influence testosterone levels without reflecting a direct hormonal benefit.

Crucially, while short-term nicotine exposure may cause a temporary spike in testosterone due to stress hormone interactions, long-term nicotine use tends to have the opposite effect.

Comparing Forms of Nicotine and Their Effects

1. Cigarette Smoking

Cigarette smoke contains over 7,000 chemicals, many of which are toxic to reproductive tissues. Despite occasional reports of elevated testosterone levels in smokers, research has also linked cigarette smoking to impaired sperm quality, reduced fertility, and erectile dysfunction.

One study found that chronic smoking was associated with decreased levels of inhibin B - a marker for sperm production - and increased DNA fragmentation in sperm cells, despite slightly elevated serum testosterone. These findings suggest that testosterone levels alone are not indicative of reproductive health.

2. Nicotine Gum and Pouches

Nicotine replacement therapies like gum and pouches deliver controlled doses of nicotine without the harmful byproducts of combustion. However, studies examining the hormonal effects of these delivery methods are still limited.

Some early research suggests that nicotine gum may not significantly alter testosterone levels compared to placebo. That said, more comprehensive, long-term studies are needed to draw firm conclusions.

In the case of nicotine pouches, the data is even more sparse. One recent animal study suggests potential impacts on androgen receptor expression, but human studies remain lacking.

3. Vaping and E-Cigarettes

E-cigarettes are often marketed as a safer alternative to smoking. But while they contain fewer toxins than traditional cigarettes, they still expose users to nicotine and other chemicals like propylene glycol and flavorants.

A 2023 study on male rats found that e-cigarette exposure altered testosterone levels and disrupted testicular histology. Though human data is limited, the early evidence raises concerns about long-term reproductive effects.

Why the “Higher Testosterone from Smoking” Claim Is Misleading

The idea that smokers may have “higher testosterone” is technically correct in some studies, but it’s far from a health benefit. These marginal increases are often accompanied by serious reproductive harm, including reduced semen quality and increased risk of erectile dysfunction.

Furthermore, studies showing higher testosterone in smokers often fail to differentiate between total testosterone and free testosterone (the active form). In some cases, total testosterone might be elevated due to decreased sex hormone-binding globulin (SHBG), but the free testosterone remains unaffected or even reduced.

This suggests that any apparent hormonal benefits from nicotine may be superficial—and potentially harmful in the long run.

Broader Health Impacts of Nicotine

Nicotine has widespread physiological effects, many of which are detrimental to hormone balance and cardiovascular health. It can cause vasoconstriction, reduce oxygen supply to tissues, and impair nitric oxide synthesis - all of which contribute to erectile dysfunction.

Additionally, chronic nicotine use has been associated with:

• Lower sperm count and motility
• Increased oxidative stress in reproductive organs
• Disruption of normal hormone feedback loops

Even if nicotine temporarily elevates testosterone levels, the long-term tradeoffs are unfavorable for overall male reproductive health.

Healthier Ways to Support Testosterone Naturally

If you’re concerned about low testosterone, there are safer and more effective strategies than turning to nicotine:

• Exercise regularly - especially strength training and HIIT
• Get enough sleep - 7–9 hours per night is ideal
• Manage stress - chronic stress raises cortisol, which can suppress testosterone
• Eat a balanced diet - including healthy fats, zinc, and vitamin D
• Avoid excessive alcohol and processed foods

These evidence-based approaches can help support optimal testosterone levels without the side effects of nicotine.

FAQs: Common Questions About Nicotine and Testosterone

Can nicotine increase testosterone levels?
Some studies show a small, temporary increase, but the long-term effects of nicotine - especially from smoking - are likely harmful to testosterone and reproductive health.

Does nicotine gum affect testosterone the same way smoking does?
Nicotine gum delivers nicotine without combustion toxins, but current studies show minimal to no effect on testosterone. More research is needed.

Are nicotine pouches safer for testosterone than smoking?
There’s limited human research, but early evidence suggests pouches may have fewer hormonal disruptions than smoking. Still, the long-term impact is unclear.

Why do smokers sometimes have higher testosterone?
This may be due to stress or lower body weight rather than a true hormonal benefit. High testosterone in smokers doesn’t equate to better reproductive health.

Can quitting nicotine improve testosterone?
Yes. Quitting nicotine can help restore hormonal balance and improve fertility, erectile function, and overall health over time.

How Everlywell Can Help

Curious about your testosterone levels? Everlywell offers an easy, at-home Testosterone Test that allows you to assess your hormone levels conveniently and confidentially. With physician-reviewed results and actionable insights, you can take control of your hormonal health - without needing to leave your home.

References

1. Veldhuis JD, et al. “Mechanisms of Sex Steroid Feedback Regulation of Gonadotropins.” Endocr Rev. 1988;9(2):134–165.
2. Trummer H, et al. “The Impact of Cigarette Smoking on Male Fertility.” World J Urol. 2002;20(6):385–390.
3. Pacifici R, et al. “Cigarette Smoking and Hormone Levels in Men.” J Clin Endocrinol Metab. 1993;76(3):566–571.
4. Zhang Y, et al. "Nicotine Exposure Alters Male Reproductive Hormone Levels and Sperm Quality." Sci Rep. 2024. https://www.nature.com/articles/s41598-024-74482-6
5. Ramlau-Hansen CH, et al. “Is Smoking a Risk Factor for Reduced Semen Quality?” Fertil Steril. 2007;88(1):84–89.
6. Sharma R, et al. “Effects of Cigarette Smoking on Male Reproductive Health.” J Transl Med. 2016;14:180.
7. Glover ED, et al. “Nicotine Replacement Therapy: A Double-Blind Placebo-Controlled Study.” Addict Behav. 2000;25(2):239–246.
8. Raus Balind S, et al. “Nicotine Pouches Alter Hormonal Pathways in Mice.” Toxicol Rep. 2023;10:55–62.
9. Saito T, et al. “E-Cigarette Exposure Disrupts Testicular Function.” Andrology. 2023;11(4):789–798.
10. Harte CB, Meston CM. “Effects of Smoking Cessation on Erectile Function.” Urology. 2012;80(2):302–308.
11. Tsai EC, et al. “Sex Hormone-Binding Globulin and Cardiovascular Risk.” J Clin Endocrinol Metab. 2005;90(5):2636–2641.
12. Kukreja RC, et al. “Nitric Oxide in Cardiovascular Health.” J Mol Cell Cardiol. 2001;33(6):1141–1151.
13. Vine MF. “Cigarette Smoking and Sperm Quality.” Reprod Toxicol. 1996;10(6):553–559.
14. Aitken RJ, et al. “Oxidative Stress in the Male Germ Line.” Reprod Biomed Online. 2004;9(3):337–347.
15. Kapoor D, et al. “Testosterone Replacement Therapy Improves Insulin Resistance.” Clin Endocrinol (Oxf). 2006;64(3):293–299.