Semen Quality Measures in Hookah and Cigarette Smokers Compared to Nonsmokers

Background: The relationship between smoking and human health is a well-researched and continuously evolving field. The impact of smoking on semen quality, and consequently on male fertility, has also been explored, though most studies have primarily focused on cigarette smoking rather than hookah smoking. Objective: In this study, we aimed to investigate and compare the effects of hookah and cigarette smoking on semen parameters in a sample of Jordanian males. Methods: A total of 558 participants were prospectively recruited, including 300 cigarette smokers, 95 hookah smokers, and 163 nonsmokers (control). Semen analysis was performed approximately 1 h after ejaculation following the World Health Organization guidelines (2021). Results: Interestingly, semen volume was significantly decreased in hookah smokers (p = 0.0097) but not in cigarette smokers when compared to the control group. No significant differences were observed in semen volume, progressive sperm motility, total motility, sperm count, sperm morphology (p = 0.2714, p = 0.8752, p = 0.6671, p = 8614, and p = 0.9261, respectively), and sperm vitality between hookah and cigarette smokers. Furthermore, except for semen volume, these semen parameters were not statistically different in both tested groups when compared to the control group. Conclusions: Hookah smokers demonstrated lower semen volume compared to the control group. Additionally, no significant differences were found in sperm count, percentage of sperm motility, normal forms of sperm, and sperm vitality between hookah and cigarette smokers or between these groups and the control group.