Tobacco smoking can make it harder for women and men to have children, the World Health Organization said in a new evidence summary released in Geneva on September 8. The agency linked smoking with infertility in women, impaired sperm and sexual function in men, lower success rates for some fertility treatments and possible reproductive harm from second-hand smoke.
WHO said one in six people of reproductive age experiences infertility at some point. The condition is defined as failure to achieve pregnancy after at least 12 months of regular unprotected sex. The nine-page technical document is the twelfth in the agency's tobacco knowledge-summary series and is intended to guide health professionals, policymakers and public-health advocates.
A systematic review covering studies conducted from 2000 through 2026 found that women who currently smoke had a 40 percent higher risk of infertility than women who do not smoke, according to WHO. The agency also reported that former smokers had a 25 percent lower risk than women who continued smoking, a comparison that indicates quitting may make a meaningful difference.
The summary also examined male reproductive health. WHO cited a review of 44 studies involving more than 60,000 men that associated smoking with semen abnormalities and sexual dysfunction. Reported problems included erectile and ejaculation disorders, absence of sperm in semen, reduced sperm movement and abnormal sperm shape. ANSA reported that waterpipe use may also affect male fertility.
For people receiving assisted reproduction, WHO cited earlier research across 21 studies linking cigarette smoking with fewer pregnancies and live births. The findings suggested that smoking could roughly halve the chances of successful outcomes after procedures such as in vitro fertilization. Women exposed to second-hand smoke may also face a higher infertility risk and a lower chance of conceiving in any month they try.
Evidence remains strongest for cigarettes, while research on electronic cigarettes, waterpipes and smokeless tobacco is still developing, WHO cautioned. The agency recommends that health workers explain tobacco-related reproductive risks to individuals and couples planning pregnancy, offer evidence-based help to quit, and routinely give brief cessation advice to tobacco users in all health-care settings.
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