WHO report warns smoking increases infertility risk in women by 40 percent
A systematic review of studies published between 2000 and 2026 found that women who currently smoke tobacco have a 40% higher risk of infertility than women who do not smoke.
SWITZERLAND—Smoking may reduce the chances of conceiving and affect reproductive health in both women and men, according to a new knowledge summary published by the World Health Organization (WHO).
The publication highlights evidence linking tobacco use to infertility in women, reduced sperm quality and sexual dysfunction in men, and lower success rates for some fertility treatments.
It also warns that exposure to second-hand tobacco smoke may affect fertility, meaning people can face reproductive risks even if they do not smoke themselves.
Smoking linked to infertility in women
Infertility affects about one in six people of reproductive age worldwide.
WHO defines infertility as the inability to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse.
Decades of research have linked smoking with poorer reproductive health among women.
A systematic review of studies published between 2000 and 2026 found that women who currently smoke tobacco have a 40% higher risk of infertility than women who do not smoke.
The evidence also suggests that quitting smoking may improve reproductive health.
Women who previously smoked but no longer do were found to have a 25% lower risk of infertility than women who continued to smoke.
Tobacco affects male reproductive health
WHO also stresses that infertility affects men as well as women.
A review of 44 studies involving more than 60,000 men found an association between smoking and reproductive problems, including abnormalities in semen and sexual dysfunction.
Men who smoke were more likely to experience erectile dysfunction and ejaculation problems.
Researchers also linked smoking with the absence of sperm in semen, reduced sperm movement and abnormal sperm shape.
Smoking may reduce fertility treatment success
Tobacco use may also reduce the likelihood of a successful outcome among people undergoing fertility treatment.
WHO cites research from 21 studies linking cigarette smoking with fewer pregnancies and live births after assisted reproductive procedures such as in vitro fertilisation (IVF).
The findings suggest that cigarette smoking may reduce the chances of successful fertility treatment by about half.
Waterpipe smoking, commonly known as hookah or shisha, may also affect male fertility.
Second-hand smoke poses reproductive risks
People who do not smoke may also face fertility risks through exposure to tobacco smoke.
WHO reports that women exposed to second-hand smoke may have a higher risk of infertility and a lower probability of conceiving during each month they attempt pregnancy.
However, evidence on newer tobacco and nicotine products, including e-cigarettes, waterpipes, and smokeless tobacco, remains limited and continues to develop.
WHO says the strongest evidence currently concerns cigarette smoking, although other products may also pose risks to reproductive health.
WHO recommends that health care providers discuss the reproductive effects of tobacco use with individuals and couples planning pregnancy and provide evidence-based support to help them quit.
It also calls for brief smoking cessation advice to be routinely offered to all tobacco users across health care settings.
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