Could Vapers Be Denied NHS IVF

Merseyside and Cheshire NHS services have recently announced a raft of restrictions on publicly-funded IVF, one of which denies treatment to those who vape. Does the data support this exclusion, or is this another example of vapers being treated like second-class citizens?

What sort of IVF does the NHS fund?

Western birth rates are plummeting. We’re also having babies later. So, it’s no surprise that more couples need to access in vitro fertilisation (IVF) to have children.

However, IVF is costly. Some estimates suggest a single round comes with out-of-pocket costs of as much as £7,500 per cycle. Additionally, due to a variety of factors, there is no guarantee that any of these rounds will yield results, with women under 35 requiring an average of 1 in 3 rounds to get pregnant, and those over 40 years old having as little as 5% chance per round.

Understandably, the NHS does offer couples some help. However, typically, it comes with a wide range of health and lifestyle restrictions, such as:

• Maternal age.
• BMI limits.
• Smoking status.
• If you already have children.
• Prior treatments.
• Duration of time the parents have tried to conceive.
• Clinical factors like levels of ovarian reserve and other health considerations.

As things are, Cheshire and Merseyside currently have ten separate subfertility policies, meaning access to NHS IVF varies widely across the region. A six-week public consultation that ran over the summer (3 June to 15 July 2025) aimed to gather feedback on standardising the process so that everyone across the local area gets the same IVF allowance and faces equitable eligibility requirements.

Where does vaping fit into all of this?

The restrictions that the NHS puts on IVF eligibility are theoretically about success rates. The Cheshire and Merseyside NHS spends over £5million per year on IVF. The proposed change to one cycle per eligible person would save an estimated £1.3 million annually. So, it’s fair to say they’re just as much a cost-cutting exercise. But what concerns me most is the sloppiness around

Proposed Change 3 from the public consultation.

Now, there is plenty of research into the impact of smoking on the ability to conceive and birth healthy kids.

Some outcomes from studies that are worth considering include:

• Smokers had a 50% lower implantation rate than never smokers. [1]
• Current smokers had a 41.8% increased risk of infertility compared to never smokers. [2]
• Smokers undergoing Assisted Reproductive Technology (ART) had significantly lower odds of clinical pregnancy and live birth per cycle.[3]
• The fertility of smokers is estimated at 72% of non-smokers. [4]
• Smokers were 3.4 times more likely to take more than a year to conceive than non-smokers. [4]

When it comes to publicly-funded IVF, there are limited funds. So, you can understand how certain lifestyle factors that decrease the likelihood of success might exclude particular parties.  Smoking, substance abuse, and a high BMI have a well-researched impact on IVF. However, the same cannot be said of vaping.

Much of the research on the impact of vaping on fertility struggles to separate the effects of prior smoking. Sadly, just as in many other trials, a person can smoke for twenty years, then vape for six months, and the damage they’ve done to their body is attributed to vaping. Indeed, some of the studies on vaping and male sperm health specifically note that their results may be biased by previous smoking history and that results should not be interpreted as proof vaping is independently harmful or safe. And yet, these statements have not stopped vapers getting the short end of the NHS stick.

The fact is that the research isn’t strong enough to deny people IVF and their dreams of bringing a child into the world. Similarly, when people stop smoking and switch to vaping, it improves their fertility significantly.

Final thoughts

We’ve all got used to a particular piece of linguistic trickery when it comes to vaping. It goes something like: “Smoking and vaping kill 8 million people per year.” This false equivalence conflates smoking deaths per annum (8 million) with vaping deaths (zero).

Seeing researchers and health bodies fall into this trap is disappointing. However, when this chicanery is used to exclude people who can’t afford private IVF from treatment, it becomes somehow even more greasy and unethical.

Let’s hope the NHS sees sense and doesn’t use this as an excuse to save money while punishing vapers for not smoking.