Hello dear Understand your concern I think smoking and alcoholism in your case cause erectile dysfunction and low libido in your case. Other causes are: diabetes, hypertension. obesity, low testosterone, neurogenic and psychological problem should be rule out. Go for following investigation by consulting the urologist: seminal fluid examination, blood sugar, lipid profile, blood pressure measurement etc. I give following advice: First stop smoking and alcohol. Do regular exercise like walking and yoga daily in the morning for 45-60 minutes, take high protein diet, fresh fruits and green leafy vegetables, drink lots of water, take diet rich in anti oxidant like almonds 5-6/day, tablet Co Q, avoid excessive sweets, spicy and fatty foods. Be relax while doing sex, use comfortable position like women on top position, involve more in foreply before sex, do kegel s exercise and pelvic exercise, do sex when you feels energetic, talk to your partner regarding your problem that relieve your anxiety If above advises do not help then you can take tablet sildenafil plus paroxentine after proper evaluation. Testosterone injections should be given weekly for low testosterone hormone. Hope this may help you Best regards Dr. Sagar