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As most people now realize, smoking can be very damaging to your overall health, increasing your risk of heart disease in particular. Smoking’s damage to the cardiovascular system comes primarily from its effects on blood flow.

The chemicals in tobacco smoke damage the delicate endothelial cells that line the inner walls of your arteries, which in turn restricts blood flow. And to achieve and sustain an erection, it is essential that your penis receives strong blood flow.

Several years back, a team of Iranian researchers studied the effects of smoking cessation on former smokers who were able to quit through the use of nicotine replacement therapy or NRT. The research team recruited 281 smokers who expressed a desire to quit through the use of NRT.

Only 118 of the study participants successfully gave up smoking, while 163 were unable to quit that habit. Among those who were successful in quitting, 25 percent reported significant improvement in their erectile function a year after quitting smoking.

Q. I’ve read that doctors sometimes give newborn babies the same active ingredient that’s in Viagra. Obvious the treatment of erection problems, so what medical purpose does the drug serve in newborns?

A. It’s true that some newborns, most premature babies, are given small amounts of sildenafil, the active ingredient in Viagra. This is done to improve the respiratory function of infants whose lungs may not be fully developed at birth.

Sildenafil is also marketed at lower doses as a treatment for pulmonary arterial hypertension, a form of high blood pressure that targets the lungs and puts a strain on both the lungs and heart. By dilating the blood vessels in and around the lungs, the blood pressure is lowered and breathing is improved.

And lowering the blood pressure in the lungs reduces the heavy burden on the heart. As the child grows and the lungs, as well as the arteries that supply them, become more fully developed, the need for this extra help from sildenafil is reduced. But it has proven to be a lifesaver for premature babies born with pulmonary hypertension.

Viagra, along with Levitra, Cialis, Staxyn, and Stendra, all belong to a family of medications known as PDE5 inhibitors. They are so called because they all temporarily disable an enzyme known as phosphodiesterase-5, which can interfere with blood flow to the penis, particularly in men whose vascular health is less than robust.

While all these drugs are similar in chemical structure, there is enough variation from one to another that you might find one work better for you than the others. Or you may find that they all produce the desired results, but one or more of them might cause you bothersome side effects. You will probably need to give each of these drugs a try to determine which is best for you. Viagra, Levitra, Staxyn, and Stendra all tend to become effective 30 to 60 minutes after they are taken, and all remain effective for four to six hours.

Cialis, in both it’s 10- and 20-milligram doses, is much longer lasting — up to 36 hours, earning it the nickname of the “weekend drug.” All of these medications have similar side effects, the most common of which are back pain, diarrhea, dizziness, flushing, headache, muscle ache, runny or stuffy nose, and upset stomach. Such side effects, if they occur at all, tend to be relatively mild and usually disappear upon continued use of the drug.

Q. I have heard that generic Viagra is on its way and will soon be introduced in the United States, but I’ve heard that it’s already been on the market in a number of other countries, including Canada, the member countries of the European Union, and China. If I travel to one of those countries, can I legally purchase a Viagra generic and bring it back to this country?

A. Technically, it is illegal to import prescription drugs — particularly those that are not yet legal here — from outside the country. In practice, however, customs agents tend to look the other way when the amount of the drug being brought into the country is of an amount consistent with personal use — usually a supply of up to 90 days. However, because it is illegal, you could well run into the customs agent who’s having a bad day and thus decides to confiscate your stash of generic Viagra.

You have no legal grounds on which to protest such a confiscation, and you’re out whatever money you spent to buy it abroad. We would recommend patience, because, in December 2017, generic Viagra is slated to go on the market in the United States.

The first generic formulation of the drug will come from the U.S. subsidiary of Israeli-based Teva Pharmaceuticals, which is the world’s biggest manufacturer of generic drugs. Another version of generic Viagra from Mylan will follow shortly thereafter, and within six months or so, the variety of generic Viagra available will increase even further.

Q: I know that Pfizer is the pharmaceutical company that developed Viagra back in the 1990s, but I heard that the drug’s active ingredient wasn’t originally envisioned as a treatment for ED. What did Pfizer’s researchers hope to do with sildenafil?

A: Originally synthesized by a team of pharmaceutical scientists at Pfizer’s research laboratory in Sandwich, England, sildenafil citrate was code-named UK-92480. Members of the research team, which included Andrew Bell, David Brown, and Nicholas Terrett, hoped that the compound could be used to relieve the chest pain of angina pectoris and also bring down high blood pressure that was unresponsive to other drugs.

During trials, they were unimpressed by the drug’s ability to achieve the hoped-for goals, but they noticed a surprising side effect among male study participants. Those given the drug suddenly found it very easy to get and keep an erection.

This was also observed in some men who had previously experienced serious erection problems. Shortly thereafter, the Pfizer research team scrapped the study of the drug for treating angina and high blood pressure and began a study to see how effectively sildenafil-treated erectile dysfunction.

Clinical trials were encouraging, and Pfizer soon began petitioning drug regulatory agencies, including the U.S. Food and Drug Administration, for permission to market the drug as a treatment for ED.

Q: My insurer won’t cover my prescriptions for Viagra or for any other ED drug. However, I read recently that the Defense Department spends millions each year to cover the cost of ED drugs for both active-duty servicemen and veterans. Why do they get coverage when civilians can’t?

A: According to a report in an article posted at MilitaryTimes.com in 2015, the Pentagon paid more than $84 million to purchase erectile dysfunction drugs for its active-duty troops, dependents, and veterans. Nearly half of that sum — $41.6 million to be exact — went toward Viagra.

However, much of those expenditures went to cover the cost of ED drugs for servicemen — both active-duty and veterans — who were suffering from post-traumatic stress disorder or PTSD.

Sexual dysfunction is rampant among both male and female service personnel who have PTSD. In men, the most common form of PTSD-related sexual dysfunction is ED, while in women, it is vaginal pain. It is estimated that up to 85 percent of the servicemen suffering from PTSD also suffer from erection problems.

And their inability to have sexual relations with their intimate partners tends to exacerbate their symptoms of PTSD. Helping them to regain erectile function is just one step on their road to recovery.

Q: The print and broadcast media are full of reports about so-called female Viagra. How Does the Female Viagra Drug for Women Differ from the Viagra Designed to Treat ED symptoms?

A: As Pfizer discovered in its trials of Viagra in women test subjects, female sexuality is fundamentally different from that of males. While men usually find their desire for sex growing (pun intended) as they become aroused, the same phenomenon is not observed in women. Pfizer’s trials revealed that Viagra did little or nothing to affect women’s desire for sex, the lack of which is the primary form of female sexual dysfunction.

Scientifically, it is known as hypoactive sexual desire disorder or HSDD. The quest for a way to counter HSDD has more recently focused on brain chemistry and how it might be rebalanced to increase sexual desire.

Addyi, a drug that first went on sale in the United States in October 2015, is designed to decrease brain levels of serotonin, a hormone known to inhibit sexual desire. It is also designed to increase brain levels of dopamine and norepinephrine, both of which are believed to increase sexual desire.

Although it’s been on the market for a couple of years, it has not been the roaring success that its advocates predicted. A number of different factors are to blame. The increase in sexual desire among women taking the drug has been estimated at one-half to one additional satisfying sexual event a month, and the drug must be taken daily to achieve those modest results.

Add to that the reluctance of insurers to cover the drug, and it’s easy to see why Addyi has not taken off in the way its manufacturer hoped. Another factor holding down sales of Addyi has been the prohibition of alcohol consumption for as long as a woman is on Addyi.

Under current law, Viagra and all the other PDE5 inhibitors are available only by prescription in the United States. However, reports from the United Kingdom indicate that country’s Medicines and Healthcare Products Regulatory Agency has recommended that the drug be made available over the counter.

It would be sold in packets of six tablets of 50 milligrams each. Viagra has been facing generic competition in the United Kingdom since mid-2013, so if it succeeds in its bid to take Viagra over the counter, it would be another way of competing with the generic versions of the drug.

And the United Kingdom is not the first market in which Pfizer has made a bid to market an OTC formulation of its pioneering drug. Several years earlier, Pfizer sought approval from the European Medicine Agency to do the same throughout the nations of the European Union. However, it withdrew that application when the agency voiced concerns about the idea. If the OTC scheme is successful for Pfizer in the United Kingdom, it might make a similar bid to introduce an OTC version of the drug in The United States.