THE IMPACT OF CIGARETTE SMOKING ON SEMEN QUALITY AND MALE FERTILITY: A REVIEW OF CURRENT EVIDENCE

Katarzyna Bednarczuk; Aleksandra Irena Skuza; Marta Góral; Dominik Fidorowicz; Daniel Sagan; Katarzyna Helena Sergiel; Rafał Siedlecki; Emilia Torbacka; Magda Downar-Zapolska; Agnieszka Mikłaszewicz

doi:10.31435/ijitss.3(51).2026.5836

Authors

Katarzyna Bednarczuk Independent Public Provincial Integrated Hospital in Szczecin – Arkońska, Szczecin, Poland https://orcid.org/0009-0000-5207-6718
Aleksandra Irena Skuza Independent Public Provincial Integrated Hospital in Szczecin – Arkońska, Szczecin, Poland https://orcid.org/0009-0000-3071-2015
Marta Góral Independent Public Provincial Integrated Hospital in Szczecin – Zdunowo, Szczecin, Poland https://orcid.org/0009-0004-1063-897X
Dominik Fidorowicz Independent Public Provincial Integrated Hospital in Szczecin – Arkońska, Szczecin, Poland https://orcid.org/0009-0005-2184-4004
Daniel Sagan Independent Public Provincial Integrated Hospital in Szczecin – Arkońska, Szczecin, Poland https://orcid.org/0009-0007-8247-9842
Katarzyna Helena Sergiel Independent Public Provincial Integrated Hospital in Szczecin – Arkońska, Szczecin, Poland https://orcid.org/0009-0002-6627-9852
Rafał Siedlecki Independent Public Provincial Integrated Hospital in Szczecin – Zdunowo, Szczecin, Poland https://orcid.org/0009-0005-2653-2368
Emilia Torbacka Pomeranian Medical University Hospital No.2 – Szczecin, Poland https://orcid.org/0009-0001-4624-3564
Magda Downar-Zapolska Independent Public Provincial Integrated Hospital in Szczecin – Arkońska, Szczecin, Poland https://orcid.org/0009-0008-4646-0404
Agnieszka Mikłaszewicz Pomeranian Medical University Hospital No.1 – Szczecin, Poland https://orcid.org/0009-0007-7423-6103

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.5836

Keywords:

Cigarette Smoking, Male Infertility, Semen Quality, Public Health

Abstract

Male infertility represents a major global health concern, with lifestyle-related factors increasingly recognised as contributors to lowering reproductive potential. Cigarette smoking is one of the most significant modifiable risk factors affecting male fertility due to the presence of toxic compounds capable of inducing oxidative stress, DNA damage, and impaired spermatogenesis. This literature review summarises current evidence published in articles regarding the impact of cigarette smoking and alternative nicotine products on semen quality and male fertility. The reviewed studies consistently demonstrated that smoking is associated with reduced semen volume, sperm concentration, total sperm count, and motility, alongside increased sperm DNA fragmentation and epigenetic alterations. Oxidative stress emerged as the central pathogenic mechanism, reinforced by mitochondrial dysfunction, abnormal DNA methylation, reduced antioxidant capacity, and formation of DNA adducts. Conventional semen analysis may underestimate smoking-related fertility impairment, as molecular and epigenetic abnormalities may persist despite apparently normal semen parameters. Smoking cessation was consistently associated with improvements in semen quality, particularly in sperm concentration and total sperm count, with longer abstinence producing greater recovery. Alternative nicotine products, including e-cigarettes, snus, and hookah, were also linked to adverse reproductive effects, although their degree of toxicity may differ from that of conventional cigarettes. Overall, current evidence supports smoking cessation as an important intervention for improving male reproductive health and highlights the need for further research into molecular markers of fertility impairment beyond routine semen analysis.

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