How smoking affects female and male fertility

If you are trying for a baby, quitting smoking is the best thing you can do.  

Stopping smoking can help improve your chances of getting pregnant. It will also dramatically reduce your risk of pregnancy complications such as:

• miscarriage
• ectopic pregnancy
• premature labour and birth
• stillbirth.

Smoking also increases the risk of sudden infant death syndrome (SIDS) after your baby is born. SIDS is the sudden, unexpected and unexplained death of an apparently healthy baby.

Stopping smoking can be hard. But there is lots of support available.  

Smoking and getting pregnant 

If you smoke, it may take you longer to get pregnant than a non-smoker.

The more you smoke, the longer it may take you to get pregnant. Even low levels of smoking (between 5 and 9 cigarettes a day) can make it more difficult.

Smoking and fertility

Infertility is when a couple cannot get pregnant despite having regular, unprotected sex for a year or more.  

Women and birthing people who smoke are twice as likely to be infertile as non-smokers. This is true if you are trying to become pregnant for the first time and if you have been pregnant before.

Smoking can also affect the success rates of fertility treatment, such as IVF (In vitro fertilisation).

Find out more about fertility and the causes of infertility.  

Secondhand smoke  

Secondhand smoke (passive smoking) can also affect your chance of getting pregnant.

Find out more about the risks of secondhand smoke. 

Can I improve my chances of getting pregnant if I stop smoking? 

Yes. The good news is that women and birthing people who stop smoking don’t take any longer to get pregnant than people who have never smoked.

Stopping smoking will also improve your chances of getting pregnant if you are using fertility treatment, such as IVF. 

Men, smoking, and fertility 

Smoking also affects a man’s fertility (the ability to get a woman or birthing person pregnant).  

Stopping smoking can reverse some of this damage. Quitting can:

• improve sperm count and quality.
• reduce the risk of impotence (the inability to get and maintain an erection) over time.

Male smoking can also reduce the chances of fertility treatments such as IVF working.

Find out more about improving fertility in men.

When should I stop smoking?

It is ideal if you can stop smoking at least 4 months before getting pregnant but stopping at any point really helps.  

Can I cut down instead of stopping altogether? 

Even low levels of smoking can make getting pregnant more difficult and is harmful to your pregnancy. For example, smoking 1-5 cigarettes a day, is a risk factor for ectopic pregnancy. Smoking fewer cigarettes does not reduce the risk of premature birth or low birth-weight.

Low-tar or low nicotine cigarettes are just as harmful to you and your baby’s health.

If you stop smoking before you get pregnant then all your risks will become as low as for women and birthing people who have never smoked.

Find out more about the effects of smoking when you are pregnant.

What is Nicotine replacement therapy (NRT)? 

Nicotine replacement therapy (NRT) is safe to use if you are trying to get pregnant. NRT only contains nicotine and none of the damaging chemicals found in cigarettes.

NRT products include:

• patches
• nicotine chewing gum
• lozenges
• inhalators
• nasal or mouth spray.

Stop smoking tablets such as varenicline (including Champix, which isn't being prescribed in the UK now) or Zyban (bupropion) are not recommended in pregnancy. So try to avoid these if you are trying to get pregnant because you may not realise you are for the first few weeks.  

Speak to your GP, a pharmacist or a specialist stop smoking adviser before using any NRT products.  

Liquorice-flavoured nicotine products

If you are trying to get pregnant it is best to avoid liquorice-flavoured nicotine products.  

Research has shown that excessive amounts of liquorice root can affect a baby’s development.  

There is no known risks with small amounts of liquorice flavouring, but the manufacturers advise that it is best to be careful. There are other flavours available, such as fruit or mint.

Can I use e-cigarettes to quit?

Many smokers use e-cigarettes (also known as vapes or e-cigs) to help them stop smoking.  

There has not been much research into the safety of e-cigarettes in pregnancy. The vapour from an e-cigarette contains some of the potentially harmful chemicals found in cigarette smoke, but at much lower levels.

If you feel that your e-cigarette is helping you to stay smoke free, then you should continue to use it. But there are ways to quit smoking that have been shown not to cause any other harm. This includes nicotine replacement therapy (NRT) and support from NHS Smokefree services.

I may already be pregnant. Am I too late to stop smoking?

No. It’s never too late. Every extra day your baby develops in the womb without toxins from cigarette smoke will make a big difference to your health in pregnancy and beyond.

Stopping smoking during pregnancy reduces the risk of your baby being ill in the first month of life. This does not mean that smoking in the first trimester is safe. The earlier you stop smoking the healthier you and your baby will be.  

Your mental health

Some people say that the stress of stopping smoking is worse for the baby than smoking. The research shows that this is not true. Stopping smoking can improve mood and help relieve stress, anxiety and depression. Taking care of your mental wellbeing as well as your physical health before pregnancy is important.  

Find out more about positive ways to manage your mental health while trying to get pregnant.

How do I stop smoking?

There is lots of support available to help you stop smoking. You are twice as likely to be successful at quitting if you get some support from a trained adviser.

NHS Smokefree 

The NHS Smokefree helpline offers free help, support and advice on stopping smoking and can give you details of local support services. Call NHS Smokefree helpline: 0300 123 1044  

Your local GP surgery or pharmacist can help you find your nearest NHS Stop Smoking service.

You can also download the NHS Quit Smoking app.

Action on Smoking and Health (ASH) 

ASH is a charity that works to raise awareness about tobacco use and campaigns for ways to eliminate the damage caused by smoking. You can find information about different aspects of smoking and quitting, along with links to more stop smoking websites.