Is it Safe to Smoke While Taking Birth Control Pills? 


Editorial Team


June 7, 2024

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Medical review by: Andrea Eisenberg, MD


  • Smoking or vaping while on birth control increases some of the risks, including heart disease and stroke.
  • The mix of nicotine and birth control, especially for women over 35, raises the likelihood of blood clots, stroke, and heart attack and may decrease contraceptive effectiveness.
  • The risk of heart problems is higher for those with a family history of heart disease, high blood pressure, or obesity issues, on top of smoking and taking oral contraceptives.
  • Smokers can choose safer birth control choices, including non-hormonal methods like copper IUDs, barrier methods like condoms, and progestin-only options, particularly for those under 35.

What are the Risks of Smoking & Vaping?

Smoking is a known risk factor for various health complications, particularly cardiovascular diseases like heart disease and stroke, and using birth control while actively smoking or vaping can increase that risk. 

Vaping is also known to have adverse health effects. While it may be considered less harmful than smoking traditional cigarettes, vaping still poses health risks, particularly to the respiratory and cardiovascular systems. 

How Does Smoking or Vaping Interact With Contraceptives?

When you smoke and take birth control pills, the combination can be hazardous for women over the age of 35. It increases the chance of developing serious health issues like:

  • Blood clots
  • Stroke
  • Heart attack

It can also affect the way your body processes contraceptive hormones, which may impact the pills’ effectiveness, increasing the likelihood of an unplanned pregnancy. 

It’s important to seek advice from your doctor regarding the most suitable contraception method for your individual needs. Your doctor can also guide you on how to quit smoking and minimize your risk of developing severe health complications.

What Increases Negative Side Effects?

The combination of age, smoking, and taking oral contraceptives can put you at a significantly higher risk for heart problems. And it’s not just older women or heavy smokers who are affected – you’re also at risk if you have:

  • A family history of heart disease
  • High blood pressure
  • Problems with obesity

Talking with your healthcare provider can ensure you have all the facts regarding your health and lifestyle before deciding a route to take with birth control.

I Smoke. What Options Do I Have?

If you’re a smoker looking for birth control, know that you’ve got safe options:

  • Copper IUDs offer protection without the risks tied to hormonal contraceptives. 
  • Barrier methods such as condoms are simple and risk-free relative to smoking. 
  • Progestin-only options–including progesterone only pills, progesterone IUD, and progesterone implant–may also be a safer choice, especially if you’re under 35. 

Regardless of your situation, our friendly healthcare professionals are here to help. With the proper research and knowledge, you can feel confident your contraceptive choices are right for you.

Frequently Asked Questions About Nicotine & Birth Control

How does smoking affect the efficacy of birth control pills?

Smoking can alter how your body metabolizes contraceptive hormones, potentially reducing the effectiveness of birth control pills and increasing the risk of an unplanned pregnancy.

Is it riskier to smoke while on birth control if I’m over 35?

Yes, women over 35 who smoke and use birth control pills face a significantly higher risk of developing serious health issues such as blood clots, stroke, and heart attacks compared to younger women and non-smokers.

Can vaping be a safer alternative to smoking while on birth control?

While vaping is often perceived as less harmful than traditional cigarettes, it still poses health risks, especially to the cardiovascular and respiratory systems. The full effects of vaping while on birth control are still being studied, but caution is advised due to the potential risks.

Can I reduce the health risks associated with smoking and birth control?

Quitting smoking is the most effective way to reduce the health risks associated with using birth control while smoking. If quitting is not an option, switching to a lower-risk birth control method and regular monitoring by a healthcare provider can help manage and mitigate risks.

  1. Centers for Disease Control and Prevention. (2024, May 15). Smoking & Tobacco Use. Accessed online March 28, 2024 at
  2. Centers for Disease Control and Prevention. (2024, May 15). Smoking & Tobacco Use. Accessed online March 28, 2024 at
  3. Medline Plus. (2015, September 15). Estrogen and Progestin (Oral Contraceptives). Accessed online March 28, 2024 at
  4. Stenchever MA. (1993, December). Risks of oral contraceptive use in women over 35. J Reprod Med. Accessed online March 28, 2024 at
  5. Shufelt, C., & LeVee, A. (2020). Hormonal Contraception in Women With Hypertension. JAMA, 324(14), 1451–1452.


Editorial Team


June 7, 2024

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment or medication.