Effects of tobacco chewing habits on male infertility


  • Bhavna Borkhataria Embryologist, Candor IVF Centre, Surat, Gujarat, India
  • Jaydev Dhameliya Gynecologist and Infertility Specialist, Candor IVF Centre, Surat, Gujarat, India
  • Devisha Mavani Embryologist, Candor IVF Centre, Surat, Gujarat, India
  • Juhi Dhameliya Embryologist, Candor IVF Centre, Surat, Gujarat, India




Azoospermia, Male infertility, OATS, Semen parameters, Tobacco chewing


Background: It is the fact that, India consists of world’s largest tobacco chewer population, more prevalent in low income group. The effects of tobacco chewing on semen parameters have been widely studied. The study aim is to analyze the semen analysis parameters (oligozoospermia, asthenozoospermia, teratozoospermia, oligo-astheno-teratozoospermia -OATS and azoospermia) of tobacco chewer and non chewer infertile patients.

Methods: A retrospective analysis of 639 patients was done out of which 150 were non-chewers and 489 were tobacco chewers. The percentage of population with particular semen abnormalities were compared between the two groups. The same comparison was performed between tobacco chewing primary infertility and secondary infertility patients in order to specifically assess the effect of tobacco chewing in sub-fertile patients.

Results: OATS and azoospermia cases were significantly higher in the tobacco chewing infertile patients as compared to oligozoospermia, asthenozoospermia and teratozoospermia cases. In case of sub-fertile patients also, the percentage of OATS and azoospermia were significantly higher.

Conclusions: This finding suggest that tobacco chewing greatly affects every parameter of sperm i.e. concentration, motility and morphology collectively. Moreover, tobacco chewing may be less affecting the male fertility initially but prolonged exposures affects detrimentally resulting in serious semen parameter abnormalities such as OATS and even azoospermia. And such cases are difficult to treat even with higher and advanced infertility treatment options like ICSI, microfludics, etc. This reduces the chances of IVF success as well as increases the financial burden on the patients undergoing infertility treatment. Thus, infertility clinics must employ awareness programs for such patients to explain them the effects of tobacco chewing habit and reducing it can definitely enhance the treatment outcomes.


Jensen CFS, Khan O, Nagras ZG, Sønksen J, Fode M, Østergren PB, et al. Male infertility problems of patients with strict sperm morphology between 5-14% may be missed with the current WHO guidelines. Scand J Urol. 2019;3:1-5.

Machen, Luke G, Jay I. Sandlow. Causes of Male Infertility. Male Infertility. Springer; 2020:3-14.

Bowa K, Kachimba JS, Mapulanga V, Chalwe M, Manda E. Male infertility from the developing nation perspective. In Male Infertility. Springer, Cham. 2020:855-63.

Rai T, Rai GS. Cigarette smoking and alcohol consumption are enemy of male fertility? A patho-radiological correlation study. Int J Res Med Sci. 2016 Mar;4(3):847-54.

US NCI and WHO. The economics of tobacco and tobacco control. National Cancer Institute (Tobacco Control Monograph 21, NIH Publication No.16-CA-8029). Bethesda, MD; 2016. Available at: http://cancercontrol.cancer.gov/brp/tcrb/monographs/21/index.html. Accessed 15th March 2020.

Tata Institute of Social Sciences and Ministry of Health and Family Welfare Government of India, 2017. Global Adult Tobacco Survey GATS 2 India 2016-2017 Report.

Spangler JG. Smokeless tobacco: epidemiology, health effects and cessation strategies. Am Fam Physician. 1995 Oct;52(5):1421-30.

Bates C, Fagerström K, Jarvis MJ, Kunze M, McNeill A, Ramström L. European Union policy on smokeless tobacco: a statement in favour of evidence-based regulation for public health. Tobacco Control. 2003 Dec 1;12(4):360-7.

Boyle P, Ariyaratne MY, Barrington R, Bartelink H, Bartsch G, Berns A, et al. Tobacco: deadly in any form or disguise. Lancet. 2006;367(9524):1710-2.

Jorsaraei SGA, Jorsaraei SGA, Shibahara H. The in-vitro effects of nicotine, cotinine and leptin on sperm parameters analyzed by CASA system. Int J Reprod Biomed. 2012;6.

Hoffmann D, Djordjevic MV. Chemical composition and carcinogenicity of smokeless tobacco. Adv Dent Res. 1997 Sep;11(3):322-9.

Künzle R, Mueller MD, Hänggi W, Birkhäuser MH, Drescher H, Bersinger NA. Semen quality of male smokers and nonsmokers in infertile couples. Fertility Sterility. 2003 Feb 1;79(2):287-91.

Saleh RA, Agarwal A, Sharma RK, Nelson DR, Thomas Jr AJ. Effect of cigarette smoking on levels of seminal oxidative stress in infertile men: a prospective study. Fertility Sterility. 2002;78(3):491-9.

Stillman RJ, Rosenberg MJ, Sachs BP. Smoking and reproduction. Fertili Steril. 1986;46(4):545.

Vine MF, Chiu-Kit JT, Hu PC, Truong KY. Cigarette smoking and semen quality. Fertility Sterility. 1996 Apr 1;65(4):835-42.

Dikshit RK, Buch JG, Mansuri SM. Effect of tobacco consumption on semen quality of a population of hypofertile males. Fertility Sterility. 1987;48(2):334-6.

Vogt HJ, Heller WD, Borelli S. Sperm quality of healthy smokers, ex-smokers, and never-smokers. Fertility Sterility. 1986;45(1):106-10.

Lewin A, Gonen O, Orvieto R, Schenker JG. Effect of smoking on concentration, motility and zona-free hamster test on human sperm. Arch Androl. 1991;27(1):51-4.

Kahar, Payal, Ranjita Misra, and Thakor G. Patel. Sociodemographic correlates of tobacco consumption in rural Gujarat, India. BioMed research international .2016;2016.

WHO laboratory manual for the examination and processing of human semen Fifth edition. 2010

Said TM, Ranga G, Agarwal A. Relationship between semen quality and tobacco chewing in men undergoing infertility evaluation. Fertility Sterility. 2005 Sep 1;84(3):649-53.

Chemes HE, Sedo CA. Tales of the tail and sperm headaches changing concepts on the prognostic significance of sperm pathologies affecting the head, neck and tail. Asian J Androl. 2012 Jan;14(1):14.

Chemes HE. Phenotypes of sperm pathology: genetic and acquired forms in infertile men. J Androl. 2000;21(6):799-808.

Hamamah S, Fignon A, Lansac J. The effect of male factors in repeated spontaneous abortion: lesson from in-vitro fertilization and intracytoplasmic sperm injection. Human Reproduction Update. 1997;3(4):393-400.

Sunanda P, Panda B, Dash C, Ray PK, Padhy RN, Routray P. Prevalence of abnormal spermatozoa in tobacco chewing sub-fertile males. J Human Reproductive Sci. 2014;7(2):136.

Oyeyipo IP, Raji Y, Emikpe BO, Bolarinwa AF. Effects of nicotine on sperm characteristics and fertility profile in adult male rats: a possible role of cessation. J Reproduc Infertil. 2011 Jul;12(3):201.

Collin O, Kilter S, Bergh A. Tobacco smoke disrupts testicular microcirculation in the rat. Inter J Androl. 1995 Jun;18(3):141-5.

Sharpe RM, Maddocks S, Millar M, Kerr JB, Saunders PT, McKinnell C. Testosterone and Spermatogenesis Identification of Stage‐Specific, Androgen‐Regulated Proteins Secreted by Adult Rat Seminiferous Tubules. J Androl. 1992 Mar 4;13(2):172-84.

Kapawa A, Giannakis D, Tsoukanelis K, Kanakas N, Baltogiannis D, Agapitos E, et al. Effects of paternal cigarette smoking on testicular function, sperm fertilizing capacity, embryonic development, and blastocyst capacity for implantation in rats. Andrologia. 2004 Mar;36(2):57-68.

Pasqualotto FF, Lucon AM, Sobreiro BP, Pasqualotto EB, Arap S. Effects of medical therapy, alcohol, smoking, and endocrine disruptors on male infertility. Revista Hospital Clíni. 2004;59(6):375-82.

Pakrashi A, Chatterjee S. Effect of tobacco consumption on the function of male accessory sex glands. Int J Androl. 1995 Oct;18(5):232-6.

Zenzes MT. Smoking and reproduction: gene damage to human gametes and embryos. Human Reproduction Update. 2000 Mar 1;6(2):122-31.

Kiziler AR, Aydemir B, Onaran I, Alici B, Ozkara H, Gulyasar T, Akyolcu MC. High levels of cadmium and lead in seminal fluid and blood of smoking men are associated with high oxidative stress and damage in infertile subjects. Biol Trace Element Res. 2007 Dec 1;120(1-3):82-91.

Danis RB, Samplaski MK. Sperm Morphology: History, Challenges, and Impact on Natural and Assisted Fertility. Curr Urol Reports. 2019;20(8):43.




How to Cite

Borkhataria, B., Dhameliya, J., Mavani, D., & Dhameliya, J. (2020). Effects of tobacco chewing habits on male infertility. International Journal of Research in Medical Sciences, 8(7), 2589–2593. https://doi.org/10.18203/2320-6012.ijrms20202900



Original Research Articles