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Year : 2006  |  Volume : 22  |  Issue : 2  |  Page : 161-162

Tobacco chewing and male infertility

Department of Urology, All India Institute of Medical Sciences, New Delhi - 110002, India

Correspondence Address:
Rajeev Kumar
Department of Urology, All India Institute of Medical Sciences, New Delhi - 110002
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How to cite this article:
Kumar R, Gautam G. Tobacco chewing and male infertility. Indian J Urol 2006;22:161-2

How to cite this URL:
Kumar R, Gautam G. Tobacco chewing and male infertility. Indian J Urol [serial online] 2006 [cited 2023 Apr 2];22:161-2. Available from:

Said TM, Ranga G, Agarwal A. Relationship between semen quality and tobacco chewing in men undergoing infertility evaluation. Fertil Steril 2005; 84: 649-53.

   Summary Top

Factors causing impaired fertility in men are not completely known. Tobacco use is a potential detrimental factor. The authors performed a study to assess the relationship between sperm characteristics and tobacco chewing in Indian men, who were part of an infertile couple.

The study was conducted in Mumbai. Six hundred and thirty-eight male patients aged 18-40 years who were part of an infertile couple, were grouped according to the frequency of their tobacco chewing habit into mild (< 3 times/day, n = 177), moderate (3-6 times/day, n = 264) and severe (> 6 times/day, n = 197). All patients had a history of tobacco chewing of 4-10 years duration, but no other relevant social habits. These men underwent a semen analysis using WHO guidelines and comparisons were made using the ANOVA and t-tests.

Sperm concentration (a mean of 77.95 versus 47.59 versus 27.25 million per ml), percentage motility (a mean of 60.87 versus 56.69 versus 49.29%), morphology (a mean of 33.79 versus 27.0 versus 18.62%) and percentage viability (a mean of 64.1 versus 59.38 versus 52.55%) were significantly higher in the mild group vs. the moderate group and in the moderate group vs. the severe group. The percentage of men with azoospermia rose with the level of addiction (1, 3 and 14%), as did the percentage of men with oligoasthenoteratozoospermia (2, 8 and 29%), although the differences were not statistically significant.

The authors conclude that tobacco chewing is strongly associated with a decrease in sperm quality and to a lesser extent with oligoasthenozoospermia or azoospermia. Infertile men should therefore be counselled about the adverse effects of tobacco chewing on sperm quality and should be encouraged to give up the habit.

   Comments Top

The relationship between tobacco use and male fertility has always been controversial. There have been reports which suggest that tobacco use, primarily through smoking, may be detrimental to sperm function and there have also been reports to the contrary.[1],[2],[3],[4] Tobacco chewing is considered a milder form of tobacco use but is highly prevalent in India, particularly among the lower socio-economic groups. Its association with oral cavity cancer is well established and this cancer is the commonest malignancy among Indian men, attesting to the widespread nature of this habit.

This study by Said et al is an important eye-opener to the possible ill-effects of this habit on the fertility potential of men. As the authors themselves state, it often affects those who have the least potential to seek expensive remedies such as assisted reproduction. The study has found a significant association between the number of times tobacco is chewed and the sperm counts, motility and morphology. The morphology may actually decline from normal to abnormal in moderate and heavy smokers. While these results look consistent with the hypothesis of tobacco effect on germ cells, this study does not attempt to correlate duration of tobacco use with its effects. Moreover, it seems that only one semen sample per patient was evaluated and in view of the variability of semen quality, at least two or three reports per patients would have been advisable. The authors also fail to exclude patients with other known causes of male factor infertility, which would have allowed stratification of only those patients where tobacco use may be considered the primary problem.

Nonetheless, this study suggests that tobacco use is a potential cause of male infertility and since this is a potentially correctable condition through adequate pubic health measures, it deserves further evaluation.

   References Top

1.Sofikitis N, Miyagawa I, Dimitriadis D, Zavos P, Sikka S, Hellstrom W. Effects of smoking on testicular function, semen quality and sperm fertilizing capacity. J Urol 1995;154:1030-4.   Back to cited text no. 1  [PUBMED]  
2.Kunzle R, Mueller MD, Hanggi W, Birkhauser MH, Drescher H, Bersinger NA. Semen quality of male smokers and nonsmokers in infertile couples. Fertil Steril 2003;79:287-91.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Trummer H, Habermann H, Haas J, Pummer K. The impact of cigarette smoking on human semen parameters and hormones. Hum Reprod 2002;17:1554-9.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Vogt HJ, Heller WD, Borelli S. Sperm quality of healthy smokers, ex-smokers and never-smokers. Fertil Steril 1986;45:106-10.  Back to cited text no. 4  [PUBMED]  

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