Short answer: Research strongly indicates that smoking negatively affects fertility in both women and men. Smoking is linked to reduced ovarian reserve, longer time to conceive, and increased risk of miscarriage, and sperm quality can also be affected. The good news is that the risks decrease when you quit – and it's never too late to stop smoking.
How smoking can affect female fertility
There is relatively strong evidence that smoking is associated with reduced fertility in women. A review referenced by the American Society for Reproductive Medicine (ASRM) found that the risk of infertility was about 1.6 times higher in women who smoke compared to non-smokers (odds ratio 1.60). Smoking also appears to accelerate the loss of eggs in the ovarian reserve – studies indicate lower levels of the AMH hormone in smokers – and can lead to earlier menopause by an estimated one to four years. These are statistical correlations at the group level, and how much an individual is affected can vary.
Smoking, miscarriage and pregnancy
Evidence suggests that smoking increases the risk of miscarriage and ectopic pregnancies, and that nicotine can affect the ability to conceive. According to 1177, you should not use nicotine – neither through smoking nor snus – when trying to conceive or when pregnant, as nicotine can affect fertility and poses risks to the fetus. During pregnancy, smoking is linked to, among other things, poorer fetal growth and an increased risk of premature birth.
Can smoking affect male fertility?
The picture for men is more complex. There is some support for the idea that several sperm parameters – such as count and motility – are, on average, worse in men who smoke than in non-smokers, and the effect appears to be dose-dependent. At the same time, the evidence is not sufficient to definitively state that smoking itself significantly reduces male fertility; however, it is linked to an increased risk of early pregnancy loss. Overall, the precautionary principle suggests that men trying to conceive also benefit from avoiding tobacco.
What happens when you quit?
The encouraging news is that the body begins to recover soon after quitting smoking. Quitting smoking is one of the most concrete things one can do for their reproductive health, and it's never too late. If you find it difficult, help is available – maternity clinics, healthcare centers, and the free Stop Smoking Line (020-84 00 00) can provide support. Note that nicotine replacement therapies such as patches and gum are not recommended during pregnancy according to 1177; talk to your healthcare provider about what support is right for you.
Frequently Asked Questions
Is snus better than cigarettes if I want to get pregnant?
No, snus also contains nicotine, and 1177 advises against nicotine both when trying to conceive and during pregnancy. The nicotine in snus can affect fertility and poses risks to the fetus.
Are e-cigarettes a safe alternative?
The evidence does not support e-cigarettes (so-called ENDS) as a safe alternative to regular cigarettes. Furthermore, there is a lack of studies on how e-cigarettes affect the fetus, and 1177 advises against them during pregnancy.
If I quit smoking now – will it help?
The evidence suggests it will. Risks decrease when you quit, and the body begins to recover relatively quickly. It's never too late to stop smoking.
This text is general information and does not constitute medical advice. Always consult with a midwife, doctor, or other healthcare professional for advice regarding your specific situation.