A critical review of reports on the effect of smoking on sex and fertility

Abstract

This review describes the accumulated clinical and experimental evidence and evaluates the methods used for investigations on the relationship of smoking and sexual behavior and fertility.

Most of the observations on humans are based on clinical impressions or on population surveys over the smoking habits of fertile and non‐fertile individuals or of individuals with various sexual “difficulties”, Most current population studies draw their study samples from individuals who are self‐selected for sexual problems and not for smoking habits. Individual uses of stimulants or depressants (of which smoking may be only one simple instance) are not taken into consideration. Some reports imply that there is a difference in physical and/or psychological dimensions between smokers and non‐smokers although no dominant and consistent differences in physical or psychological traits emerges between the various groups studied. There is a reported decrease of testosterone level in smokers when compared to non‐smokers and an increase in this testosterone level following the cessation of smoking. But, even if the depression in testosterone levels are found to be a consistent consequence of smoking, the significance of this depression would still appear to be unclear. Sexual behavior has been shown to continue unabated even when androgenic hormones were considerably decreased or even completely absent.

Animal research tends to show that there are many factors affecting the sexual behavior and physiology of animals. A high level of stimulation with tobacco smoke or an injection of nicotine appears to interfere with sexual behavior and lead to organ atrophy. However, lower levels of tobacco extracts have no comparable effect and in some investigations even appear to have increased the sexual “drive” observed in animals.

While there are no clear data, the general conclusion is inescapable that existing evidence does not support the hypothesis that smoking or tobacco extracts have an effect on sexual activity or procreation.