Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team. Updated on January 4th, 2021

There are risks associated with both smoking and oral contraceptives, and mixing the two can be a deadly combination. Smoking is known to restrict one’s blood vessels, causing blood clots that lead to cardiovascular issues. On the other hand, oral contraceptives affect the body’s hormonal makeup, making one’s blood thicker than usual.

Simply put, the synergistic effects of smoking and using birth control leads to a greater risk of cardiovascular issues like strokes or heart attacks.

If you’re both a smoker and a user of birth control, check out the below information about how smoking affects various contraceptive methods.

What happens if you smoke on birth control?

On average, women who smoke die seven years earlier than women who do not smoke; for women on birth control, the adverse health effects of smoking are even riskier. Quitting smoking improves health outcomes for women and also makes it less dangerous to use birth control.

Your blood vessels are usually soft and pliable which helps to transport blood to the brain and other vital internal organs. The toxic chemicals in tobacco cause the blood vessels to constrict, so the heart has to work harder to pump blood around the body.

Numerous scientific studies have shown that cigarette smoking comes with severe consequences, including cardiovascular diseases like blood clots, heart attacks, and strokes . All three of these medical conditions are potential side effects of common hormonal birth control While birth control pills can increase the risk of blood clots by three to four times, the overall risk is still minimal with only 1 in 3000 women who take birth control are at risk of blood clots. That said, your risk of experiencing blood clots, heart attacks, or a stroke is significantly higher when you combine smoking and taking hormonal pills The adverse side effects are even more prominent if you’re over 35 years of age. Women aged 35 and up who smoke have the highest risk of experiencing cardiovascular side effects from birth control. If you are older than 35 and smoke, be sure to explore alternative solutions to birth control with your doctor.

Starting hormonal birth control without informing your doctor that you’re a smoker can seriously damage your cardiovascular health so be sure to inform them about your history of smoking before discussing birth control options.

Is it safe to vape on birth control?

Although vaping devices have been marketed to help people quit smoking, vaping has not been approved by the United States Food and Drug Administration (FDA) as a legitimate smoking cessation device. Some studies have also shown that most people who started vaping to quit smoking cigarettes continued to smoke both regular cigarettes and e-cigarettes So you may be wondering, can vaping carry the same risks as smoking while on birth control?

Currently, there are nine million adults in the U.S. who vape. That said, vaping is relatively new to the market, and there are very few studies on the effects of vaping and birth control.

Nicotine, the active ingredient in vaping products and cigarettes, increases the risk of blood clots and adversely impacts the cardiovascular system of someone who takes birth control. Despite the lack of definitive studies in this realm, it’s safe to say that vaping should be avoided while taking combination oral contraceptives as well as the patch, the ring, or injections.

What types of birth control are safe for women who smoke or vape?

Staying away from smoking is the best choice for your overall health, but if you do smoke, there are birth control options available to you.

If you’re over the age of 35 and smoking more than 15 cigarettes per day, do not use the combined pill, patch, or ring as they can pose a huge risk to your cardiovascular health; consider the copper IUD which does not contain estrogen. Plus, most barrier methods like condoms, diaphragms, and cervical caps, are effective ways to avoid unintended pregnancy.

Still, these forms do not offer the added health benefits that women can get when they take the pill, including protection from bone density loss and prevention of ovarian and uterine cancers.

When deciding which birth control method is right for you, you must discuss your medical history with your doctors – regardless of whether you smoke or vape.

It’s also a good idea to discuss and formulate a plan for quitting smoking or vaping.


Unfortunately, tobacco and nicotine are highly addictive , and it is incredibly difficult for many women to quit smoking, despite the dangers. Studies show that eight out of ten women will continue to smoke while taking the pill even after their doctors warn them about the risks and side effects of smoking while on oral contraceptives.

In some cases, women who smoke aren’t even aware that smoking is a problem when it comes to hormonal contraceptives. Unfortunately, the majority of surveyed women do not know that there are safe contraceptive alternatives for smokers. Plus, other surveys indicate that up to half of all women who got a prescription for birth control did not inform their doctors of their smoking habits.

Although newer, lower-dose estrogen pills are safer than older generations of contraceptive pills for smokers to use, they still aren’t entirely risk-free.

Pandia Health is here to help you to find a birth control method that’s safe and effective for you.

Sign up today to get access to our knowledgeable, helpful doctors and FREE delivery of your birth control directly to your home.

Regardless of your smoking habits and reasons for using birth control, your health is our priority. #SkiptheTrip to the pharmacy and never run out of birth control on our watch


Can you use cannabis while on birth control?

Some studies have pointed out that THC elevates blood pressure and when combined with birth control, there could be some negative effects. That said, there isn’t enough research on CBD and birth control to say anything conclusively.

Can I smoke while on an IUD?

The IUD is highly effective and can be used safely by women who smoke . If you’re a smoker, the best-case scenario to avoid side effects from birth control while protecting yourself against pregnancy is to quit smoking.

How long after quitting smoking can I use birth control?

We recommend that you use progestin-only birth control until you quit smoking for an entire year. In general, it takes about 12 months for heart risks associated with smoking to be cut in half after you quit smoking.

Do birth control pills alone increase the risks of blood clots or cardiovascular issues?

The risk of blood clots or cardiovascular issues from taking birth control pills alone is relatively insignificant. In most cases, the increase in blood thickness isn’t a concern most women must worry about.

How does estrogen increase the risk of blood clots?

Overall, men are more likely than women to suffer from blood clots. However, hormones that are unique to female biology increase the risk of blood clots in some women; in particular, estrogen increases clotting factors in the blood, which is why pregnant women are at high risk of blood clots since estrogen levels rise during pregnancy.

Can you vape on birth control?

Despite the lack of definitive studies in this area, it’s safe to say that vaping should be avoided while taking combination oral contraceptives as well as the patch, the ring, or injections.

Does nicotine affect birth control?

Yes, it is possible. Nicotine increases the risk of blood clots and adversely impacts the cardiovascular system of someone who takes birth control.

Can you smoke after taking plan B?

Smoking will not affect the results of the morning after pill.

Does weed affect birth control?

Studies have shown that THC, a substance found in Cannabis, elevates blood pressure and supports the risk of blood clots. In rare cases birth control can also contribute to blood clots, thus if combined can increase the risks of blood clots even more. Dr. Sophia Yen also talks about the possible effects hard drugs can have on birth control.

Why is it bad to smoke while on birth control?

Short answer: smoking and while using birth control can lead to a greater risk of cardiovascular issues such as strokes and heart attacks.

What happens if you smoke while on the pill?

The blood vessels in your body transport blood to the brain and other vital internal organs. The toxic chemicals in tobacco cause the blood vessels to constrict, so the heart has to work harder to pump blood around the body.

Disclaimer: The views expressed in this article intend to inform and induce conversation. They are the views of the author and do not necessarily represent the views of Pandia Health, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice.