WHO Warns Smoking May Reduce Chances of Having a Baby

Geneva (GNP): Smoking may reduce the chances of conceiving for many people worldwide, according to a new World Health Organization (WHO) knowledge summary examining the links between tobacco use and fertility.

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 success rates for some fertility treatments. It also warns that second-hand smoke can affect fertility, meaning people do not need 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, with infertility defined as the failure to achieve pregnancy after 12 months or more of regular unprotected sex. Against this backdrop, the WHO publication draws on decades of evidence examining how tobacco use affects reproductive health in both women and men.

On women’s health specifically, a systematic review of studies conducted between 2000 and 2026 found that women who currently smoke tobacco face a 40% higher risk of infertility compared with non-smokers. The same body of evidence found that women who had smoked in the past but had since quit had a 25% lower risk of infertility compared with women who continued smoking, suggesting that quitting tobacco can make a meaningful difference to fertility outcomes.

The publication stresses that infertility is not solely a women’s health issue. A separate review of 44 studies involving more than 60,000 men found that smoking was associated with reproductive dysfunction, including semen abnormalities and sexual dysfunction. Men who smoke were found to be more likely to experience erectile dysfunction and ejaculation problems, alongside related issues such as the absence of sperm in semen, poor sperm motility and abnormal sperm shape.

For people undergoing fertility treatment, tobacco smoking may further reduce the likelihood of success. The publication cites earlier research drawn from 21 studies showing that cigarette smoking was linked to fewer live births and fewer pregnancies following assisted reproduction procedures such as in-vitro fertilisation, with findings suggesting that smoking may roughly halve the chances of a successful outcome.

The risks are not limited to those who smoke directly. The publication also warns that exposure to second-hand tobacco smoke may increase infertility risk, with women exposed to second-hand smoke shown to face a higher risk of infertility and a lower chance of conceiving in any given month they try.

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While evidence on newer nicotine products, including e-cigarettes, waterpipes and smokeless tobacco, is still emerging, the WHO notes that evidence remains strongest for cigarette smoking specifically. It cautioned that other tobacco and nicotine products may also pose risks to fertility and called for further research into these products.

In light of these findings, the WHO recommends that healthcare providers inform individuals and couples planning pregnancy about the reproductive risks associated with tobacco use and offer evidence-based support to help them quit. The organisation further recommends that brief advice on quitting tobacco be consistently offered to all tobacco users across all healthcare settings.