The wide range of platforms providing access to popular shows with heavy tobacco imagery multiplies the total audience for content well beyond its original distributor and can vastly increase the potential impact of tobacco imagery on young people
Some of these actions may be required under local laws

Physical causes Cardiovascular diseases such as atherosclerosis Diabetes, affecting nerve health and blood flow High blood pressure, damaging blood vessels over time High cholesterol, leading to reduced penile blood flow Obesity, which increases risk of diabetes and vascular disease Hormonal imbalances such as low testosterone Peyronies disease, causing scar tissue and painful curvature Neurological conditions like Parkinsons disease, multiple sclerosis, or spinal cord injury Medications including antidepressants, antihistamines, and certain blood pressure drugs Substance abuse of tobacco, alcohol, or illicit drugs Sleep disorders such as sleep apnea Psychological causes Everyday stress and performance anxiety Anxiety and depression affecting sexual desire Relationship problems reducing intimacy and arousal Other factors Aging, as older men more often have contributing health issues Injuries to nerves or arteries controlling erection What are the symptoms of erectile dysfunction

For more information on recent reevaluation efforts, please refer to the documents under the Wave 1 cost measure comprehensive reevaluation (2022-2023) section of the QPP Cost Measure Information page at