Dear Dr. Lovemy question is this: Can smoking effect getting a good hard erection? I am a 43 yr old male in fairly good shape except I smoke a pack a day. Can this effect the heart and blood flow. I also get cold feet(in the literal sence) I’m happily married to the same woman for 20 yrs and have always had a good sex life with her. I have a hard time getting a good hard ( normal) erection and this is straining our relationship. Hope you can help