Tobacco smoking may reduce people’s chances of conceiving and could harm fertility in both women and men, the World Health Organization has warned.
In a knowledge summary published on Tuesday, WHO, on its website, said tobacco use was associated with infertility in women, harmful effects on sperm and sexual function in men, and potentially lower chances of success with some fertility treatments.
The agency also warned that people who do not smoke themselves may face reproductive risks through exposure to second-hand tobacco smoke.
“Smoking may reduce the chances of conceiving for many people worldwide,” WHO said, citing evidence from decades of research.
Globally, one in six people of reproductive age will experience infertility at some point in their lifetime, according to WHO.
The agency defines infertility as “the failure to achieve pregnancy after 12 months or more of regular unprotected sex.”
WHO said a systematic review of studies conducted between 2000 and 2026 found that women who currently smoke tobacco had a 40 per cent higher risk of infertility than those who did not smoke.
The agency also highlighted evidence suggesting that quitting could make a difference.
It said women who had smoked tobacco in the past but were no longer smoking had a 25 per cent lower risk of infertility compared with women who continued to smoke.
WHO stressed that infertility should not be regarded solely as a women’s health issue.
“A recent review of 44 studies involving more than 60 000 men found that smoking was associated with reproductive dysfunction, including semen abnormalities and sexual dysfunction,” it said.
According to the agency, the evidence showed that men who smoke were more likely to experience erectile dysfunction, ejaculation problems and related reproductive issues, including absence of sperm in semen, poor sperm motility and abnormal sperm shape.
The potential impact extends to people seeking medical help to conceive.
WHO said earlier research involving 21 studies found that cigarette smoking was associated with fewer pregnancies and live births following assisted reproduction, including in vitro fertilisation.
The findings suggested that the chances of successful outcomes “may be roughly halved by cigarette smoking.”
WHO also warned that second-hand smoke exposure could affect fertility.
“Women exposed to second-hand smoke may have a higher risk of infertility and a lower chance of conceiving each month they try,” the agency said.
However, WHO said evidence concerning newer tobacco and nicotine products remained limited.
“Evidence is strongest for cigarette smoking, but WHO warns that other tobacco and nicotine products may also pose risks to fertility and require further research,” it said.
The agency said evidence on products including e-cigarettes, waterpipes and smokeless tobacco was still emerging.
WHO recommended that healthcare providers inform individuals and couples planning pregnancy about the reproductive risks associated with tobacco use and provide evidence-based support to help them quit.
It also recommended that brief advice on quitting should be consistently offered to all tobacco users in healthcare settings.
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