This document is the twelfth in a series of Tobacco Knowledge Summaries and is prepared with the objective to summarize the current evidence on the association between tobacco use and infertility. This concise advocacy tool aims to inform and mobilize health professionals, policymakers, and advocates.

Infertility is defined as a failure to achieve pregnancy after 12 months or more of regular unprotected sexual intercourse. One in six people experience infertility in their lifetime. Infertility is caused by multiple factors. Cigarette smoking and exposure to second-hand tobacco smoke are associated with infertility in women. While the adverse effects of cigarette smoking on women’s reproductive health are well documented, evidence is still emerging regarding use of other tobacco products, including waterpipe and smokeless tobacco, and nicotine products such as e-cigarettes. Current data suggest potential risks to fertility, but further research is required to fully characterize these effects. For men, cigarette smoking is associated with harmful effects on semen and sperm and on sexual function, which can lead to infertility. omen who quit smoking may have a lower risk of infertility compared with women who continue to smoke. WHO recommends that healthcare providers inform individuals and couples planning pregnancy about the reproductive risks of tobacco use and offer evidence-based support to help them quit.