The publication, which reviewed evidence on tobacco use and fertility, also linked smoking among men to reproductive dysfunction, including poor sperm quality, erectile dysfunction and ejaculation problems
A new knowledge summary by the World Health Organisation (WHO) has revealed that women who currently smoke tobacco have a 40 per cent higher risk of infertility than non-smokers.
The publication, which reviewed evidence on tobacco use and fertility, also linked smoking among men to reproductive dysfunction, including poor sperm quality, erectile dysfunction and ejaculation problems.
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WHO warned that exposure to second-hand tobacco smoke could also affect fertility, meaning people who do not smoke themselves may still face reproductive health risks.
Infertility is defined as the inability to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse.
The WHO said one in six people of reproductive age worldwide experience infertility at some point in their lifetime.
Smoking and infertility
According to the publication, decades of research have established a link between tobacco smoking and women’s reproductive health.
It cited a systematic review of studies conducted between 2000 and 2026 which found that women who currently smoke tobacco had a 40 per cent higher risk of infertility compared with women who do not smoke.
The review also found that women who had smoked in the past but were no longer smoking had a 25 per cent lower risk of infertility compared with women who continued to smoke.
The findings, WHO said, suggest that quitting tobacco could make a meaningful difference to reproductive health.
Men also affected
WHO stressed that infertility should not be regarded solely as a women’s health issue.
It cited a recent review of 44 studies involving more than 60,000 men, which found that smoking was associated with reproductive dysfunction.
The evidence linked smoking among men to semen abnormalities and sexual dysfunction, including erectile dysfunction and ejaculation problems.
It also found associations with the absence of sperm in semen, poor sperm motility and abnormal sperm shape.
Waterpipe smoking, commonly known as hookah or shisha, was also identified as a potential risk to male fertility.
Fertility treatment
The WHO publication further warned that smoking could reduce the chances of successful fertility treatment.
It cited earlier research involving 21 studies which found that cigarette smoking was associated with fewer pregnancies and fewer live births following assisted reproductive procedures such as in-vitro fertilisation (IVF).
The findings suggested that cigarette smoking could roughly halve the chances of successful outcomes from some fertility treatments.
Second-hand smoke
People do not necessarily have to smoke themselves to face potential fertility risks, WHO warned.
The publication said women exposed to second-hand tobacco smoke may have a higher risk of infertility and a lower chance of conceiving during each month they try.
However, WHO noted that evidence on newer tobacco and nicotine products, including e-cigarettes, waterpipes and smokeless tobacco, is still emerging.
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The organisation said evidence is currently strongest for cigarette smoking, while other tobacco and nicotine products may also pose risks to fertility and require further research.
Quitting support
WHO urged health-care providers to discuss the reproductive risks of tobacco use with individuals and couples who are planning pregnancy.
It recommended that health-care providers offer evidence-based support to help tobacco users quit.
The organisation also recommended that brief advice on quitting should be provided consistently to all tobacco users across health-care settings.
The WHO said addressing tobacco use should form part of efforts to protect reproductive health, particularly as infertility affects millions of people globally.