Tobacco smoking may reduce the chances of conceiving and affect reproductive health in both women and men, according to a new World Health Organization (WHO) knowledge summary. Evidence links smoking with infertility in women, sperm abnormalities and sexual dysfunction in men, while second-hand smoke may also affect fertility.
Globally, around one in six people of reproductive age experience infertility at some point. A review of studies from 2000 to 2026 found that women who currently smoke have a 40% higher risk of infertility compared with non-smokers. Among men, smoking has been associated with poor sperm motility, abnormal sperm shape, semen abnormalities, erectile dysfunction and ejaculation problems.
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Smoking may also reduce the success of fertility treatments such as in vitro fertilization (IVF), with research linking cigarette use to fewer pregnancies and live births. WHO recommends that healthcare providers discuss the reproductive risks of tobacco use with people planning pregnancy and provide evidence-based support to help them quit.
