A study published in the American Journal of Preventative medicine concluded that Men who use e-cigarettes or vape are more than twice as likely to suffer from erectile dysfunction than those who have never used the nicotine-based smoking alternatives.

The study’s authors noted that vaping enthusiasts needed to be warned about the potential impact on their sexual health.

Data analysed from 14,000 American men between the ages of 20 and 65 found that regular e-cigarette users were around 2.2 times more likely to experience impotence than non-smokers.

However the study did not factor in participants that were taking medications that could increase the risk of erectile dysfunction, such as antidepressants or heart medication.

Regardless, they stressed the mountain of evidence already linking smoking and nicotine to sexual dysfunction – suggesting that the high level of nicotine in vaping liquid reduces blood flow to the penis and interferes with the normal functions of blood vessels, though this was not confirmed or proven.

As part of the study, the researchers pointed to a potential connection to the chemicals contained in e-cigarette “refill liquids that may reduce testosterone levels in the human body and impair normal erectile function.

One of the Authors, Omar El Shahawy, told Insider:

“Overall, e-cigarettes are likely less harmful than smoking cigarettes to the degree that they substitute cigarette smoking,” the study’s lead author, . He added that men who view vaping as a healthier alternative should try to “limit” the habit as it is “simply not risk free.”