News release

From: World Health Organization (WHO)

Tobacco smoking may be harming your chances of having a baby

Smoking may reduce the chances of conceiving for many people worldwide, according to a new World Health Organization knowledge summary

Smoking may reduce the chances of conceiving for many people worldwide, according to a new World Health Organization knowledge summary. The publication highlights evidence that tobacco use is associated with infertility in women, harmful effects on sperm and sexual function in men, and potentially lower chances of success of some fertility treatments. It also warns that second-hand smoke can affect fertility, meaning people do not have to smoke themselves to face possible reproductive risks.

Globally, one in six people of reproductive age will experience infertility at some point in their lifetime. Infertility is defined as the failure to achieve pregnancy after 12 months or more of regular unprotected sex.

The publication cites decades of evidence showing that smoking can harm women’s reproductive health. A systematic review of studies conducted between 2000 and 2026 found that women who currently smoke tobacco have a 40% higher risk of infertility compared to those that do not smoke.

The publication also notes that women who smoked tobacco in the past but are not currently smoking may have a 25% lower risk of infertility compared with women who continue to smoke, suggesting that quitting tobacco can make a meaningful difference.

The publication stresses that infertility is not only 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. The evidence indicated that men who smoke were more likely to have erectile dysfunction, ejaculation problems, and related issues such as absence of sperm in semen, poor sperm motility and abnormal sperm shape.

For people using fertility treatment, tobacco smoking may reduce the chance of success. The publication cites earlier research from 21 studies showing that cigarette smoking was linked to fewer live births and fewer pregnancies following assisted reproduction, like invitro fertilization, with findings suggesting that the chances of successful outcomes may be roughly halved by cigarette smoking. Waterpipe smoking, also known as hookah or shisha, may also affect male fertility.

The publication also warns that exposure to second-hand tobacco smoke may increase infertility risk. Women exposed to second-hand smoke may have a higher risk of infertility and a lower chance of conceiving each month they try.

Evidence on newer products, including e-cigarettes, waterpipes and smokeless tobacco, is still emerging.

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. WHO recommends that health-care providers inform individuals and couples planning pregnancy about the reproductive risks of tobacco use and offer evidence-based support to help them quit. WHO also recommends that brief advice on quitting be consistently provided to all tobacco users in all health-care settings