Tobacco smoking may significantly reduce the chances of conceiving, with women who smoke facing a 40 per cent higher risk of infertility than non-smokers, according to a new World Health Organization (WHO) knowledge summary.
The report highlights growing evidence linking tobacco use to infertility in women, poor sperm quality and sexual dysfunction in men, as well as reduced success rates for some fertility treatments.
Infertility is defined as failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse.
In a press release today, WHO also warns that exposure to secondhand tobacco smoke may affect fertility, meaning people who do not smoke themselves but are around smokers’ environments can still face reproductive health risks.
Globally, about one in six people of reproductive age experience infertility at some point in their lives.
The WHO publication cites a systematic review of studies conducted between years 2000 and 2026, which found that women who currently smoke tobacco had a 40 percent higher risk of infertility compared with non-smokers.
It further notes that women who had smoked previously but had since quit had a 25 percent lower risk of infertility compared with those who continued smoking, suggesting that quitting may improve reproductive health.
WHO said the evidence underscores the importance of helping people quit smoking before they attempt to conceive.
The health agency also stressed that infertility should not be viewed solely as a women’s health issue.
A review of 44 studies involving more than 60,000 men found that smoking was associated with reproductive problems, including abnormal semen characteristics and sexual dysfunction.
Men who smoke were more likely to experience erectile and ejaculation problems, as well as poor sperm motility, abnormal sperm shape, and absence of sperm in semen.
For people undergoing fertility treatment, cigarette smoking may also reduce the likelihood of a successful pregnancy.
WHO cited research involving 21 studies showing that cigarette smoking was associated with fewer pregnancies and live births following assisted reproductive procedures such as in-vitro fertilization (IVF), with findings suggesting that successful outcomes may be reduced by about half among smokers.
Waterpipe smoking, commonly known as shisha or hookah, may also affect male fertility, although WHO said evidence on newer tobacco and nicotine products remains limited and continues to emerge.
The agency warned that second-hand smoke exposure may also increase infertility risks, with women exposed to tobacco smoke potentially facing a higher risk of infertility and a lower chance of conceiving during each month they try.
WHO said the strongest evidence currently concerns cigarette smoking, while further research is needed to establish the reproductive effects of e-cigarettes, waterpipes, and smokeless tobacco.
The organization has urged healthcare providers to inform individuals and couples planning pregnancy about the reproductive risks associated with tobacco use and provide evidence-based support to help them quit.
It also recommends that brief advice on quitting tobacco be routinely offered to all tobacco users in health-care settings.
In Kenya, tobacco use remains a major concern, contributing to approximately 12,000 deaths annually. While the country has made significant progress in tobacco control, emerging nicotine products such as vapes, e-cigarettes, and nicotine pouches present new challenges that require stronger action and heightened vigilance.
Tobacco use is also a major, yet often overlooked, cause of infertility that affects an estimated 10 percent to 15 percent of couples.
By Wangari Ndirangu
