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

The association between smoking and male fertility and sexual health

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

Correspondence Address:
R Kumar
Department of Urology, All India Institute of Medical Sciences, New Delhi

How to cite this article:
Kumar R. The association between smoking and male fertility and sexual health.Indian J Cancer 2010;47:107-108

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Kumar R. The association between smoking and male fertility and sexual health. Indian J Cancer [serial online] 2010 [cited 2022 May 17 ];47:107-108
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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.


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