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The target population comprised of all men born in 1924, 1934 or 1944 and residing in the city of Tampere or 11 adjacent municipalities in Finland. Questionnaires were mailed to 3,143 men in 1994, to 2,864 in 1999 and to 2,510 men in 2004. The response rates were 70%, 75% and 75% respectively. ED was assessed using two questions on subjects’ erectile capacity. Logistic and Poisson regression models were used in the multivariable analyses. Current smoking was associated with ED (Adjusted prevalence odds ratio (POR) = 1.7, 95% CI 1.2-2.4), but not with ex smoking. The incidence of ED non-significantly increased (incidence density ratio (IDR)=1.4) and that of ED recovery reduced (IDR=0.7) with current smoking. A dose-response relationship was found between smoking and ED. Although the relative risks estimates were not statistically significant, probably due to small numbers. Only heavy smokers were significantly at higher risk of ED. 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