 [ Symptoms ] how to recover from erectile dysfunction caused by tobacco use  i smoked or chewed my whole adult life there has also been some alcohol abuse as well i am currently 45 and starting 6 months after a vasectomy i had when i was 36 is when i started having problems maintaining and erection for very long and between whatever is wrong with me and the psychological stress of wanting sex but knowing i can not perform i have quit smoking drinking and using tobacco altogether i have periodontal disease the bone loss is severe i have experimented with viagra fail [ Disease ] your best bet is to look for a local community health clinic the services they offer vary but generally they include primary healthcare dental mental health and pharmacy services the clinics function as primary care for some people often low income so they will have access to physicians nurses and other ancillary healthcare providers there are about 1 200 health centers operating around the country that get some federal money you can find a clinic by searching the u s health resources and services administration website fees can run 35 to 300 depending on the type of visit and your income charges are based on a sliding scale good luck