The research was published online in the journal Tobacco Control.


  • Current or former smoking was linked with a 14% raised risk of infertility
  • At worst, passive smoking was linked with a 18% increased infertility risk
  • Menopause came 1 to 2 years earlier in those exposed to high smoke levels
  • Toxins in smoke harms reproductive system and upsets hormonal balance

Active and passive smoking are linked to infertility in women and an earlier menopause, a study has found. People who are exposed to high levels of tobacco – either through smoking themselves or passively – can experience menopause one or two years earlier than those who have never smoked or been exposed to passive smoking.  Current or former smokers were found to have a 14 per cent greater risk of infertility while passive smokers – exposed to the highest levels of fumes – were 18 per cent more likely to have trouble conceiving than non-smokers.

Researchers looked at data from 79 690 women, all aged 50 to 79 taking part in the Women’s Health Initiative Observational Study (WHI OS) who had all experienced a ‘natural’ menopause.  This means their periods had stopped for 12 consecutive months and they had not had surgery to remove their ovaries. They provided information on their lifetime smoking habits, fertility problems, and the age they went through a natural menopause. Current and former smokers were asked how many cigarettes they had smoked daily, the age they had started smoking (below 15 to over 30), and how many years they had smoked. People who had never smoked were asked if they had lived with a smoker as a child, as an adult, and if they had ever had a job where colleagues smoked in the workplace.

Fertility data was available for 13 621 women, and 15.4 per cent of these reported problems trying to conceive for at least 12 months. Being exposed to tobacco was clearly linked with a raised risk of infertility and earlier menopause, the researchers found. Compared with people who have never smoked, current or former smoking was linked with a 14 per cent greater risk of infertility. It was also associated with a 26 per cent raised risk of going through the menopause before the age of 50. The average age at the start of the menopause was significantly earlier among smokers than it was among never smokers who hadn’t been exposed to second hand smoke. And people who didn’t smoke themselves, but had been exposed to passive smoking were also at risk.

Those who had been exposed to the highest levels of tobacco smoke were 18 per cent more likely to have infertility problems than women who had never been exposed to passive smoking. This group was made up of people who had lived for 10 or more years of living with a smoker as a child, 20 or more years of living with a partner who smoked at home, and 10 or more years of working with colleagues who smoked. For this group, the menopause arrived 13 months earlier than people who hadn’t been exposed to passive smoking.

The findings held true after taking account factors including body mass index (BMI) at the age of 18, education, alcohol consumption, exercise levels, exposure to insecticides, use of oral contraceptives, and the age the woman had her first period. The researchers say the significance of going through the menopause earlier is not clear, but other studies have linked it to an increased risk of early death from any cause.

It is known the toxins found in tobacco smoke are known to have harmful effects on the reproductive system and to disrupt the production and activity of hormones linked with fertility, they explained. The researchers concluded: ‘This is one of the first studies of this size and statistical power to investigate and quantify active and passive smoking and women’s health issues. ‘It strengthens the current evidence that all women need to be protected from active and passive tobacco smoke,’


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