Tobacco use may significantly reduce fertility in both men and women, according to a new World Health Organization (WHO) publication that highlights growing evidence linking smoking and exposure to second-hand smoke with reproductive health problems.
The report comes as infertility continues to affect millions of people worldwide. According to WHO, one in six people of reproductive age will experience infertility at some point in their lives.
Infertility is defined as the inability to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse.
The publication draws on decades of scientific research showing that smoking can negatively affect women's reproductive health.
A systematic review of studies conducted between 2000 and 2026 found that women who currently smoke tobacco face a 40 per cent higher risk of infertility than women who do not smoke.
However, the report also points to evidence that quitting smoking can improve reproductive prospects. Women who smoked in the past but no longer smoke were found to have a 25 per cent lower risk of infertility compared with women who continue to use tobacco.
The findings suggest that stopping tobacco use may help reduce some of the reproductive risks associated with smoking.
WHO stressed that infertility is not solely a women's health issue.
A review covering 44 separate studies and involving more than 60,000 men found a clear association between smoking and a range of reproductive health problems.
According to the report, tobacco use was linked to semen abnormalities, reduced sperm quality and sexual dysfunction. Men who smoked were more likely to experience erectile dysfunction, ejaculation disorders and other reproductive problems.
Researchers also found evidence connecting smoking with poor sperm motility, abnormal sperm shape and the absence of sperm in semen, all of which can affect a couple's ability to conceive.
The publication also examines the impact of smoking on assisted reproductive technologies such as in vitro fertilisation (IVF).
Drawing on research from 21 studies, WHO noted that cigarette smoking was associated with lower pregnancy rates and fewer live births among people undergoing fertility treatment.
The findings suggest that smoking may reduce the likelihood of successful treatment outcomes by roughly half compared with non-smokers.
Health experts say the evidence highlights the importance of addressing tobacco use among individuals and couples seeking fertility treatment.
WHO also warned that people do not need to smoke themselves to experience potential reproductive consequences.
The report found evidence that exposure to second-hand tobacco smoke may increase the risk of infertility. Women regularly exposed to tobacco smoke from others may face a greater risk of infertility and lower chances of conceiving during each menstrual cycle.
The findings underline concerns that the effects of tobacco extend beyond smokers themselves and can impact partners and family members.
While the strongest evidence relates to traditional cigarette smoking, WHO said research into newer nicotine and tobacco products is still developing.
Products such as e-cigarettes, waterpipes and smokeless tobacco have not been studied as extensively as cigarettes in relation to fertility.
However, the organisation cautioned that these products may also carry reproductive health risks and said additional research is needed to fully understand their impact.
In response to the findings, WHO is urging healthcare professionals to discuss the reproductive risks of tobacco use with individuals and couples planning a pregnancy.
The organisation recommends that healthcare providers offer evidence-based support to help tobacco users quit and consistently provide brief smoking cessation advice in all healthcare settings.
According to WHO, increasing awareness of the relationship between smoking and fertility could help more people make informed decisions about their reproductive health and improve their chances of conceiving.
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