Smoking could significantly reduce a person’s chances of having a baby, with new evidence linking tobacco use to infertility in women, poor sperm quality and sexual dysfunction in men, as well as lower success rates in fertility treatments.
The World Health Organization (WHO) has warned that these reproductive health risks can also extend to non-smokers exposed to second-hand smoke.
The warning comes as the global health body publishes a new summary of evidence on tobacco use and fertility.
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Infertility is already a major global health problem. Approximately one in six people of reproductive age experience infertility during their lifetime. It is defined as the inability to achieve pregnancy after at least 12 months of regular, unprotected sexual relations.
Research cited by the WHO indicates that smoking can have a significant impact on female fertility.
A systematic review of studies conducted between 2000 and 2026 found that women who currently smoke tobacco had a 40 percent higher risk of infertility than women who did not smoke. The review also indicated that quitting smoking may reduce the risk.
Women who had previously smoked but had quit were found to have a 25 percent lower risk of infertility than women who continued to smoke.
The WHO added that the impact of tobacco on fertility is not limited to women.
A review of 44 studies involving more than 60,000 men found that smoking was associated with a variety of reproductive problems, including abnormal semen and sexual dysfunction.
Male smokers were more likely to experience erectile dysfunction and ejaculation problems. Smoking was also associated with reduced sperm motility, abnormal sperm shape, and the absence of sperm in semen.
These problems can make conception difficult for couples trying to start a family.
For people seeking fertility treatment, smoking can further reduce their chances of success.
The WHO summary cites research involving 21 studies that found cigarette smoking was associated with fewer pregnancies and live births after assisted reproduction treatment, including in vitro fertilization (IVF).
Evidence suggests that smoking could approximately halve the chances of a successful fertility treatment outcome. Smoking water pipes, including hookah and shisha, can also affect male fertility.
People do not necessarily need to smoke to be exposed to potential reproductive risks.
Women exposed to secondhand smoke may have a higher risk of infertility and a lower chance of becoming pregnant during each month they try to conceive.
The WHO said evidence is still emerging on newer products, including e-cigarettes, water pipes and smokeless tobacco.
While the evidence is strongest for conventional cigarettes, the organization warned that other tobacco and nicotine products could also pose risks to fertility.
WHO urges health professionals to talk to individuals and couples planning a pregnancy about the reproductive effects of tobacco use and provide them with evidence-based support to help them quit smoking.
It also recommends that brief advice on how to quit smoking be routinely offered to all tobacco users in healthcare settings..
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