Tobacco use can undermine fertility, UN health agency warns
WHO Publication Links Tobacco Use to Reduced Fertility in Both Men and Women
Qinilo.com – The World Health Organization has issued a comprehensive new report concluding that cigarette smoking very likely impairs the ability to conceive, adding weight to decades of epidemiological research connecting tobacco consumption with reproductive failure. The publication, released on Tuesday, draws together the accumulated scientific literature and delivers a clear public-health message: tobacco use is not merely a cardiovascular or pulmonary hazard — it is a measurable threat to human reproduction.
Infertility, defined by WHO as the inability to achieve a live pregnancy after at least twelve months of regular, unprotected intercourse, touches roughly one in six people worldwide. Against that backdrop, the agency’s findings carry significant weight for couples navigating the often emotionally taxing journey toward parenthood.
Women Face a Markedly Elevated Risk
The most striking figure in the report concerns female smokers: women who use tobacco carry a 40 per cent higher probability of experiencing infertility relative to their non-smoking counterparts. The mechanism is multifactorial, involving hormonal disruption, accelerated ovarian aging, and impaired implantation, though the publication frames the association primarily in epidemiological terms rather than mechanistic detail.
Dr Kerstin Schotte, Medical Officer within WHO’s Tobacco Free Initiative, distilled the agency’s guidance into a single directive aimed at anyone contemplating parenthood:
“For all people who plan pregnancies, our message is, ‘Stop smoking, improve your health, improve your reproductive health as well.'”
Men Are Not Exempt
A recurring misconception in public discourse is that infertility is predominantly a female concern. WHO’s report pushes back firmly on that assumption. A systematic review encompassing 44 studies and more than 60,000 male participants demonstrated that smoking is associated with a spectrum of reproductive dysfunction, ranging from semen abnormalities to broader sexual impairment.
Specifically, the evidence indicated that men who smoke were more likely to experience erectile dysfunction, ejaculation difficulties, and related problems including azoospermia (absence of sperm in semen), reduced sperm motility, and abnormal sperm morphology. These findings underscore that tobacco’s reproductive toll operates across both sexes and across multiple physiological pathways.
Second-Hand Smoke Extends the Risk
The report does not confine its warnings to active smokers. WHO notes that exposure to second-hand tobacco smoke can itself lower fertility, meaning that non-smoking partners — particularly women — may face diminished monthly conception probabilities simply by sharing an environment with a smoker. This dimension of the problem has historically received less public attention than direct smoking, yet the agency now places it squarely within the scope of reproductive-health risk communication.
Quitting Can Partially Reverse the Damage
One of the report’s more encouraging findings is that cessation appears to confer a measurable protective benefit. Women who had smoked in the past but had since quit exhibited approximately a 25 per cent lower infertility risk compared with those who continued tobacco use. While this does not guarantee full restoration of pre-smoking fertility, it offers a concrete, actionable incentive for smokers planning conception.
Assisted Reproduction Outcomes Are Also Affected
Tobacco use does not merely reduce natural conception rates; it also undermines the efficacy of clinical interventions. Earlier research synthesizing 21 studies linked cigarette smoking to fewer live births and fewer achieved pregnancies following assisted reproduction technologies such as in vitro fertilization (IVF). The aggregate evidence suggests that smoking could halve the probability of a successful outcome in these costly, emotionally demanding treatments — a consideration of considerable practical importance for couples already undergoing fertility therapy.
Hookah, E-Cigarettes, and Other Products
WHO also flagged waterpipe smoking — commonly called hookah or shisha — as a potential contributor to male reproductive impairment. While the evidence base for e-cigarettes (vapes), smokeless tobacco, and other newer nicotine-delivery products remains thinner and still evolving, the agency cautioned that these products may likewise pose reproductive risks and called for continued investigation.
What the Report Recommends
The publication closes with practical guidance directed at the healthcare system. Clinicians are urged to raise the reproductive risks of tobacco use explicitly with individuals and couples who are planning a pregnancy, integrating that conversation into routine preconception counselling rather than treating it as an afterthought. WHO further calls for evidence-based cessation support to be made universally available, including the routine delivery of brief quit advice to every tobacco user encountered in any healthcare setting — from primary-care clinics to hospital wards.
For the estimated 1.2 billion adults worldwide who smoke, the report reframes tobacco not only as a long-term mortality risk but as an immediate, modifiable barrier to one of life’s most fundamental biological goals. The message is straightforward: the single most effective step a prospective parent can take before any medical intervention is to put down the cigarette.
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