Millions of people trying to start a family may be facing an added obstacle they have not considered, according to a new knowledge summary from the World Health Organization. The publication links tobacco use and fertility problems in both women and men, and warns that even second hand smoke can lower the chances of conceiving.

The WHO summary, released under embargo ahead of publication on 8 September 2026, draws together decades of research on how cigarettes affect reproductive health. Globally, one in six people of reproductive age will experience infertility at some point in their lives, a condition defined as failing to achieve pregnancy after twelve months or more of regular unprotected sex. The new findings suggest that smoking and fertility risk are more closely tied together than many people realise.

The Evidence For Women

A systematic review of studies conducted between 2000 and 2026, cited in the WHO summary, found that women who currently smoke have a 40 per cent higher risk of infertility than women who have never smoked. The same review offers a note of hope for those trying to quit. Women who smoked in the past but no longer do so had a 25 per cent lower risk of infertility compared with women who continued smoking, a gap the summary says shows that stopping tobacco use can make a meaningful difference.

What Smoking Does To Male Fertility

The WHO is clear that infertility is not only a concern for women. A review of 44 studies involving more than 60,000 men, referenced in the summary, found that smoking was associated with a range of reproductive problems. Men who smoke were more likely to experience erectile dysfunction and ejaculation problems, along with semen abnormalities such as the absence of sperm, poor sperm motility and abnormal sperm shape.

The summary also flags waterpipe smoking, commonly known as hookah or shisha, as a possible contributor to male fertility problems, alongside cigarette use.

Fertility Treatment And Second Hand Smoke

For couples turning to fertility treatment, tobacco use and fertility outcomes appear to be closely connected. The WHO summary cites earlier research from 21 studies showing that cigarette smoking was linked to fewer live births and fewer pregnancies following assisted reproduction methods such as in vitro fertilisation. The research suggests the chances of a successful outcome may be roughly halved among people who smoke.

People who do not smoke themselves are not necessarily in the clear. The summary warns that exposure to second hand tobacco smoke may raise the risk of infertility in women and reduce the likelihood of conceiving in any given month of trying.

Newer Products Still Under Study

Evidence on e cigarettes, waterpipes and smokeless tobacco remains limited, though the WHO notes that these products may carry their own reproductive risks and require further research. The strongest evidence by far concerns cigarette smoking, but the summary cautions against assuming other nicotine products are a safe alternative.

What The WHO Recommends

The WHO is calling on health care providers to inform individuals and couples who are planning a pregnancy about the reproductive risks linked to tobacco use, and to offer evidence based support to help them quit. It also recommends that brief advice on stopping smoking be offered consistently to all tobacco users across every health care setting, regardless of whether fertility is the reason for their visit.

For anyone hoping to start or grow a family, the message from this latest WHO summary is straightforward. Tobacco use and fertility are linked at almost every stage of the reproductive process, from conception through to the outcome of fertility treatment, and quitting appears to offer a genuine path back towards better odds.

Source: dbrecoveryresources