Smoking and reproduction. Short and long term effects and benefits of smoking cessation

There have been many attempts during the last years to restrict smoking because of the significant health hazards. In particular the high prevalence of smoking among women in their reproductive years has been a matter of concern. This review was prompted in order to make the medical profession, and gynecologists in particular, confident with the underlying data. This will hopefully result in enabling them to provide balanced information to their patients, not overemphasizing the dangers of smoking, but rather presenting ways to properly recognize and treat tobacco dependence. It is a widely held view that the various risks imposed by smoking are very modest. A doubling of the risk for a rare problem may not prevent many women from continuing to smoke. However, a doubling of the risk for early miscarriage or a significant reduction of success rate in the treatment of infertility may be much more discouraging. The purpose of this review is to list the various effects smoking may have on the different phases of reproduction and to present an overview of the explanation models which have been suggested. Late effects on the child and its development will also be discussed. Hopefully, this will lead to proper concern about the problems and thus increase the motivation to quit smoking even before attempting a pregnancy. In addition, we give some hints on smoking cessation programs.