**4. Smoking cessation**

### **4.1 Nicotine replacement therapies**

Nicotine replacement therapies (NRTs) were the first smoking cessation medications the FDA approved for use in smoking cessation therapy. NRT is an effective and safe strategy for quit smoking. They diminished withdrawal sentiments by giving you a low, controlled amount of nicotine but none of the other dangerous compounds found in cigarettes. A low amount of nicotine makes a difference by fulfilling your need for nicotine and diminishes your smoking addiction [135, 136].

There are different varieties of NRTs, which are used in different ways. Each person can choose which variety that suits him. From person to person, the results of NRT are different. Current NRT products include transdermal patch, chewing gum, nasal sprays, lozenges, and inhalers. A combination of short- and long-acting forms of NRT is more effective for smoking cessation in comparison to the use of single forms of NRT [136, 137].

There are non-nicotine medications such as bupropion and varenicline, which are approved from FDA. Their targets are the nicotine receptors in the brain. That helps with withdrawal feelings and blocks the effects of nicotine [135, 136].

#### **4.2 Smoking cessation, reproductive health outcomes, and ART treatment**

Santos et al. evaluated sperm quality after a 3-month smoking cessation. They observed a remarkable improvement of different sperm parameters: sperm concentration, sperm vitality, motility, and percentage of spermatozoa recuperated after an enrichment technique [138].

Smoking is associated with oxidative stress. Therefore, antioxidants can be recommended in treatment of infertile smoking women [139]. In addition, patients should adopt lifestyle modifications and quitting smoking [3, 140], losing weight through

*Smoking and Its Consequences on Male and Female Reproductive Health DOI: http://dx.doi.org/10.5772/intechopen.104941*

different methods, such as diet, education, and exercise [141], and decreasing exposure to harmful toxins, such as phthalate [142].

Fecundity associated with smoking may be improved within 1 year of smoking cessation [143]. The physiological and sexual health in male smokers was improved after they quit smoking, regardless of their baseline level of erectile dysfunction [144].

If behavioral approaches did not work, the use of bupropion and/or varinecline have helped non-pregnant women to quit smoking [145]. Besides, the use of combined NRT was superior to any single NRT in treatment of individuals [146].
