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The adverse effects of smoking and alcohol on male fertility

So since when has smoking been a great idea? 1556 to be precise! It was the year an English sailor in Bristol was seen emitting smoke from his nostrils, and the novelty caught on immediately.

Although some people intensely disliked the habit, including King James I of Britain, who infamously wrote ‘A Counterblaste To Tobacco’ in 1604, there was no real pushback against smoking on grounds of ill health until 1929 in Germany.

The evils of smoking had gone unnoticed for hundreds of years because there were so many other obvious things for ordinary people to die from in that period!

All that changed in 1964 with the US Surgeon General’s Report On Smoking & Health, which lead to the first health warnings on advertising and packaging of tobacco products. Since then we have seen gradual reductions in smoking in the west.

Yet the burden of tobacco remains heavy even in high-income countries with around 30% of the male population and 20% of females indulging in the habit. Europe, in particular, has the highest rate of tobacco use among all World Health Organization regions, with men of reproductive age (20–39 years) representing nearly 46% of all smokers in this region.

The impact of smoking on fertility in males has been the subject of several studies. However, although some studies have shown that smoking adversely affects sperm quality others have shown little effect.

Similarly to tobacco smoking, alcohol consumption is considered a negative factor for male fertility due to its negative effects on reproductive hormonal levels. However, again, there is a lack of evidence regarding possible associations between alcohol intake and sperm quality.

But what happens when you mix alcohol consumption with heavy smoking? This was a question investigated by researchers at San Raffaele Hospital in Milan, Italy, and the results seem to be conclusive: combining alcohol consumption with smoking is not a good idea for male fertility.

The researchers studied 189 infertile men and classified them into groups according to whether they were smokers, alcohol consumers, or both smokers and alcohol consumers. Sperm samples were taken from the groups and investigated in terms of quality parameters and motility.

It was found that both heavy smokers and heavy drinkers, separately, had lower quality sperm than moderate smokers/drinkers and non-smokers/abstainers. More importantly, combining both heavy smoking and heavy drinking had an even more detrimental impact on sperm quality, leading to more severe forms of male infertility.

With this in mind the researchers suggest that it may well be beneficial for health care professionals to advise male patients who are seeking paternity to avoid these habits or to at least give up one of them. They also suggest that clinicians should facilitate smoking and alcohol cessation through education, monitoring, and constant support as part of the treatment for male infertility.

The expert advice is clear: would-be fathers need to sacrifice their smoking and drinking habits if they want to maximise their chances of paternity.

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