Let's talk smoking, vaping, and your fertility

Nicotine product use — and dependence — isn’t good for your health, period. Its effects on reproductive health are also well documented. But what about vaping? Is it just as bad? Below, we'll give you the lowdown on the impact of both vaping and smoking on your fertility and answer these questions:

• What should you know about smoking’s impact on fertility?

• When can you quit smoking in order to reverse the effects?

• Can secondhand smoke impact your fertility?

• Is vaping a healthier alternative to smoking?

• Does vaping cause infertility?

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The science is unequivocal on this one: In addition to the detrimental long-term health effects of smoking (cardiovascular disease, lung cancer, strokes, rheumatoid arthritis), it can also impact your fertility. According to the “Smoking and Infertility” committee opinion by the American Society for Reproductive Medicine (ASRM), “Even at one-half pack per day use, female cigarette consumption has been associated consistently with decreased fecundity.” (Fecundity = fertility.)

Here’s exactly how cigarettes can affect your reproductive system:

• Decreased egg quality and faster egg loss: Nicotine, cyanide, and carbon monoxide, the chemicals in cigarette smoke, may speed up the loss of eggs and impair the quality of eggs and the function of your ovaries.

• Earlier menopause: Smoking can result in earlier menopause (one to four years before non-smokers).

• Ectopic pregnancies: Smoking cigarettes increases the risk of ectopic pregnancy (that's when the fertilized egg attaches in a place other than the uterus).

• Sperm quality: Smoking can adversely affect sperm motility (that's sperm’s ability to move), sperm count, and morphology (that’s the shape of sperm, and cigarette smoking may cause higher numbers of abnormally shaped sperm). Smoking can also decrease sperm’s ability to fertilize eggs.

But quitting smoking makes a huge difference in your health — and that includes your fertility:

• Positive changes in eggs may be seen in women three months after smoking cessation.

• Men are advised to wait three months after quitting smoking before testing for improvement in sperm quality.

What about secondhand smoke?

A study published in the journal Tobacco Control in November 2016 examined the association between secondhand smoke consumption and early menopause (before age 50). It found that those who did not smoke, but were exposed to the highest levels of secondhand smoke, reached menopause 13 months before their non-smoking peers who had not been exposed to secondhand smoke. If you don't smoke, but your partner does (or vice versa), keep in mind that secondhand smoke can also have an impact on reproductive health.

Vaping is an alternative to traditional cigarettes that involves inhaling vapors produced by an electronic cigarette (or similar device). E-cigarettes (like JUUL) are essentially electronic nicotine delivery systems. To vape, you use a device with a cartridge containing nicotine (or tetrahydrocannabinol aka THC, the psychoactive component of the marijuana plant) and propylene glycol, and a battery. When you inhale, the nicotine is vaporized through the mouthpiece.

E-cigarette use isn't regulated in the same way as traditional cigarettes, which means there’s a lot we don’t know about what might be going into the body. For a long time, e-cigarettes were viewed as safe, but research reveals that there are possible dangers:

• As of February 18 2020 (after which this data stopped being collected), 2,807 cases of e-cigarette or vaping associated lung injury (EVALI) have been reported. According to the Centers for Disease Control and Prevention (CDC), the illnesses can be traced back to vitamin E acetate, a chemical used as an additive or thickener in some vaping products.

• In October 2019, the Food and Drug Administration (FDA) issued a warning to the public to refrain from using any vaping supplies containing THC or any vaping products that come from an unknown source.

Even before the EVALI outbreak, though, there was evidence that vaping isn't safe:

• A study published in Environmental Science & Technology in July 2016 identified harmful emissions in e-cigarette vapor, including carcinogens and irritants. (These irritants were found at a much lower level than in conventional cigarettes, but they were present enough to be dangerous.)

• The American Heart Association makes it clear that vaping isn’t a safer alternative to tobacco products — and it's not always a successful way to cut down on cigarette smoking.

• Scientists are currently conducting studies to evaluate the relationship between vaping and cancer, as well as vaping and cardiovascular health.

So, can vaping cause infertility or make you infertile?

The more research that's done, the more it's confirmed that vaping does impact fertility. In fact, after the Baptist University in Hong Kong found a link between e-cigarette toxins and fertility issues, Hong Kong called for an immediate and total ban on all e-cigarettes. How else does vaping cause infertility?

• Decreased sperm quality: Researchers at University College London found that the flavoring in “vape juice" — a mixture of water, food-grade flavoring, a choice of nicotine levels or zero nicotine, and propylene glycol or vegetable glycerin — can affect sperm and greatly diminish fertility. Specifically, the bubblegum flavor killed off cells in the testicles and the cinnamon flavor negatively impacted sperm motility.

• Delayed fertilization: A new study conducted by scientists at the University of North Carolina at Chapel Hill and published in the Journal of the Endocrine Society suggests that using e-cigarettes before conceiving delays implantation of a fertilized embryo in the uterus, thereby delaying and reducing fertility.

• Impacts on offspring: The same study from the Journal of the Endocrine Society also revealed that e-cigarette usage by pregnant women altered the long-term health and metabolism of female offspring. Kathleen Caron, PhD, an author on the study, says these findings have changed how e-cigarettes are generally perceived.

If you plan on getting pregnant in the future, staying away from all nicotine and vaping is a good idea. But both smoking cigarettes and vaping can be hard habits to kick. According to the American Cancer Society, there are a few methods to try:

• Medications: The US Food and Drug Administration (FDA) has approved seven types of smoking cessation medications to safely and effectively help people quit smoking, including nicotine gum, patches, lozenges, inhalers, nasal sprays, and two drugs (Zyban and Chantix).

• Counseling: Therapy, group counseling, and telephone counseling are all proven to help. For example, people who use telephone counseling have twice the success rate in quitting smoking as those who don’t use that type of help. (In fact, every state offers a free telephone-based program — you can call the American Cancer Society at 1-800-227-2345 to get help finding a phone counseling program in your area.) You can also find support in your community and talk with your healthcare provider about what steps to take.

• Apps: The National Cancer Institute has a quit-smoking app.

This article was medically reviewed by a member of the Modern Fertility Medical Advisory Board.

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

April 01, 2021

Written by

Chanel Dubofsky

Fact checked by

Health Guide Team

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About the medical reviewer

Health Guide Team