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Year : 2010  |  Volume : 47  |  Issue : 5  |  Page : 107-108

The association between smoking and male fertility and sexual health

Department of Urology, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication9-Jul-2010

Correspondence Address:
R Kumar
Department of Urology, All India Institute of Medical Sciences, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-509X.63876

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How to cite this article:
Kumar R. The association between smoking and male fertility and sexual health. Indian J Cancer 2010;47, Suppl S1:107-8

How to cite this URL:
Kumar R. The association between smoking and male fertility and sexual health. Indian J Cancer [serial online] 2010 [cited 2022 Dec 3];47, Suppl S1:107-8. Available from:

Smoking and tobacco use are associated with myriad pathologies. While some of these, such as lung cancer and heart disease, have been extensively studied and reported, others, such as infertility and sexual dysfunction, are rarely discussed. As a consequence, awareness of these additional ill effects of smoking is limited. A survey of the female employees of a hospital revealed that not even 1 in 4 of them was aware that smoking could result in infertility, whereas nearly all were aware that smoking could cause respiratory and cardiac diseases. [1]

The association of smoking and male sexual dysfunction has been found in both epidemiologic and clinical studies. The endothelial dysfunction that results from smoking and causes coronary artery disease also affects the penile vasculature, which is critical for initiating an erection. [2] The Massachusetts Male Aging Study found a risk of 24% of moderate and complete erectile dysfunction among smokers compared with 14% among nonsmokers. [3] Similarly, the Olmsted County database revealed an age-adjusted odds ratio of 1.42 for the risk of erectile dysfunction among ever smokers over never smokers. [4] In addition, a study of 7684 Chinese men concluded that more than 22% of all cases of erectile dysfunction could be attributed to smoking. This epidemiologic data correlates with anatomic findings of abnormal penile vasculature in more than 80% of the smokers. [5]

Although the association of smoking and sexual dysfunction appears stark, its linkages with male fertility are more tenuous, primarily because it is difficult to assess male fertility in isolation. Smoking is associated with raised levels of lead and cadmium in the blood, and these elevated levels have also been found in the semen of infertile smokers who had poorer semen parameters than nonsmokers. [6] Saleh et al. [7] noted significantly higher seminal leukocyte concentrations and reactive oxygen species levels among smokers. Others have reported abnormal sperm motility, acrosome reaction, increased DNA fragmentation, and apoptosis in the semen of smokers. [8],[9]

The ill effects of smoking on fertility are not just limited to adult exposure. Male children of women who smoked over 10 cigarettes per day during pregnancy were likely to have a sperm density 48% lower when adults. [10] Similarly, the odds ratio for adult oligospermia were found to be 2.16 if maternal smoking exceeded 19 cigarettes a day. [11]

These findings provide enough evidence that greater awareness and research is required to evaluate the effects of tobacco on male sexual and reproductive health. This becomes even more important in the light of the fact that smoking is most common in the early reproductive age groups and the rising incidence of male infertility.

  References Top

1.Roth LK, Taylor HS. Risks of smoking to reproductive health: Assessment of women's knowledge. Am J Obstet Gynecol 2001;184:934-9.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]  
2.McVary KT, Carrier S, Wessells H; Subcommittee on Smoking and Erectile Dysfunction Socioeconomic Committee, Sexual Medicine Society of North America. Smoking and erectile dysfunction: Evidence based analysis. J Urol 2001;166:1624-32.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]  
3.Feldman HA, Johannes CB, Derby CA, Kleinman KP, Mohr BA, Araujo AB, et al. Erectile dysfunction and coronary risk factors: Prospective results from the Massachusetts male aging study. Prev Med 2000;30:328-38.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]  
4.Gades NM, Nehra A, Jacobson DJ, McGree ME, Girman CJ, Rhodes T, et al. Association between smoking and erectile dysfunction: A population-based study. Am J Epidemiol 2005;161:346-51.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]  
5.He J, Reynolds K, Chen J, Chen CS, Wu X, Duan X, et al. Cigarette smoking and erectile dysfunction among Chinese men without clinical vascular disease. Am J Epidemiol 2007;166:803-9.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]  
6.Kumosani TA, Elshal MF, Al-Jonaid AA, Abduljabar HS. The influence of smoking on semen quality, seminal microelements and Ca2+-ATPase activity among infertile and fertile men. Clin Biochem 2008;41:1199-203.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]  
7.Saleh RA, Agarwal A, Sharma RK, Nelson DR, Thomas AJ Jr. Effect of cigarette smoking on levels of seminal oxidative stress in infertile men: A prospective study. Fertil Steril 2002;78:491-9.  Back to cited text no. 7  [PUBMED]  [FULLTEXT]  
8.Arabi M, Moshtaghi H. Influence of cigarette smoking on spermatozoa via seminal plasma. Andrologia 2005;37:119-24.  Back to cited text no. 8  [PUBMED]  [FULLTEXT]  
9.Sepaniak S, Forges T, Gerard H, Foliguet B, Bene MC, Monnier-Barbarino P. The influence of cigarette smoking on human sperm quality and DNA fragmentation. Toxicology 2006;223:54-60.  Back to cited text no. 9  [PUBMED]  [FULLTEXT]  
10.Storgaard L, Bonde JP, Ernst E, Spanτ M, Andersen CY, Frydenberg M, et al. Does smoking during pregnancy affect sons' sperm counts? Epidemiology 2003;14:278-86.  Back to cited text no. 10      
11.Ramlau-Hansen CH, Thulstrup AM, Aggerholm AS, Jensen MS, Toft G, Bonde JP. Is smoking a risk factor for decreased semen quality? A cross-sectional analysis. Hum Reprod 2007;22:188-96.  Back to cited text no. 11  [PUBMED]  [FULLTEXT]  

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