Tobacco use can undermine fertility, WHO warns | Report

Smoking very likely makes it harder to have a baby, the World Health Organization (WHO) warned in a new publication issued on 8 September 2026, highlighting that women who smoke have a 40 per cent higher risk of infertility compared to non-smokers, according to a press release by the UN health agency. The report summarizes decades of evidence linking tobacco use to reproductive harm in both women and men. WHO defines infertility as failing to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. The condition affects one in six people globally. The agency urged people planning a pregnancy to stop smoking to improve their reproductive health.

The WHO publication reviewed the accumulated scientific evidence connecting tobacco smoking to infertility. It noted that tobacco use is associated with infertility in women and is harmful to sperm quality and sexual function in men. Second-hand smoke can also affect fertility, meaning non-smokers face possible reproductive risks. Women who smoked in the past but quit may have a 25 per cent lower risk of infertility than those who continue. The findings underscore that quitting can make a measurable difference.

WHO stressed that infertility is not solely a women’s issue. A review of 44 studies involving more than 60,000 men found that smoking was linked to reproductive dysfunction, including semen abnormalities and sexual dysfunction. Men who smoke were more likely to experience erectile dysfunction and ejaculation problems. Related issues included absence of sperm in semen, poor sperm motility and abnormal sperm shape. The evidence points to broad reproductive risks across both sexes.

Smoking can also reduce the success of fertility treatments, WHO noted. Earlier research from 21 studies linked cigarette smoking to fewer live births and pregnancies following assisted reproduction such as invitro fertilization (IVF). The findings suggest cigarette smoking could reduce the chances of successful outcomes by roughly half. “For all people who plan pregnancies, our message is, ‘Stop smoking, improve your health, improve your reproductive health as well,’” said Dr Kerstin Schotte, Medical Officer with WHO’s Tobacco Free Initiative. Waterpipe smoking, also known as hookah or shisha, may also affect male fertility.

While evidence on e-cigarettes, waterpipes, smokeless tobacco and other new products is still emerging, WHO said these may pose reproductive risks and require further research. Exposure to second-hand smoke may increase infertility risk for women by lowering the likelihood of conceiving each month they try. The publication recommends that healthcare providers discuss the reproductive risks of tobacco use with individuals and couples planning a pregnancy. It also calls for evidence-based support to help people quit smoking. This includes the routine provision of brief cessation advice to tobacco users in all healthcare settings.