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Troubling Connection between Smoking and Male Fertility

Troubling Connection between Smoking and Male Fertility

Many know the health risks associated with smoking and female fertility, but what about smoking and male fertility?

Turns out, smoking and male fertility issues are closely linked, too.

Smoking is associated with a range of male fertility issues, such as low sperm count, poor sperm quality, and reduced sperm motility. When low sperm count or poor sperm motility are issues, infertility treatment such as in vitro fertilization (IVF) can be an effective treatment…but it can also be expensive.

As coverage of infertility treatment becomes more common—43% of companies with 500 or more workers covered IVF in 2023, up from 27% that covered IVF coverage in 2020—male infertility becomes a cost issue not to ignore.

Both employers and health plans can reduce their financial burden by helping to address smoking as an underlying cause of male infertility.

The high costs of male infertility

Male infertility represents about 50% of all fertility problems.

While smoking can affect fertility in both men and women, men are more likely to be current cigarette smokers compared to women, with 13% of men reporting smoking compared to 10% of women.

Treatment for male infertility begins with testing to determine the nature of the issue, followed by a range of interventions including hormone treatment, surgery, or assisted reproductive therapy such as IVF.

Undergoing tests and treatment for fertility issues can be extremely expensive for individuals and employers, with average costs of one IVF cycle reaching $15,000. In 14 states, insurance coverage for IVF is required for fully-insured employers and in some states, insurance is required to cover up to 3 IVF cycles.

Impact of smoking on male fertility

Smoking is considered a male infertility risk factor.

A higher number of cigarettes smoked per day and years of smoking are associated with lower semen quality, such as lower sperm count and poorer sperm motility. The chemicals found in tobacco smoke can also damage the genetic material in sperm, leading to greater difficulties with fertilization.

Smoking can affect male fertility by impacting libido and performance, too. A review of studies concluded that men who smoke have a higher risk of developing erectile disfunction (ED), independent of age and comorbidities.

In fact, males who smoked more than 20 cigarettes per day had double the risk of severe ED than those who smoked fewer cigarettes.

Plus, men who smoke were shown to have a higher risk of low sex drive compared to non-smokers.

Quitting smoking can positively affect male fertility

The good news is that the negative effect of smoking on semen quality is reversible. Quitting smoking for 3 to 6 months has been shown to improve sperm count, concentration, and motility.

Quitting smoking has also been associated with reduced depression, anxiety, and stress, which can also play a role in sexual health.

For men who are trying to conceive with their partner, quitting smoking is an essential part of improving fertility.  And offering employees and health plan members a proven quit-tobacco program such as EX Program can help.

EX Program by Truth Initiative is a digital adaptation of Mayo Clinic’s proven treatment model for tobacco use, and it works. Research shows that people who follow the EX quit plan are 4X more likely to quit.

Contact us today to see how we can help more of your population quit tobacco, or click here to see a short demo of how EX Program works to successfully engage participants in quitting.


Amanda Graham Ph.D.

Chief Health Officer

Dr. Amanda Graham leads the Innovations Center within Truth Initiative. The Innovations Center is dedicated to designing and building leading digital products for tobacco cessation, including the EX Program. She is internationally recognized as a thought leader in web and mobile quit-smoking interventions and online social networks and has been awarded over $15 million in research funding. She has published over 120 peer-reviewed manuscripts and serves on National Institutes of Health study sections and numerous journal editorial boards. Graham is Professor of Medicine (adjunct) at the Mayo Clinic College of Medicine and Science.

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