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Smoking and Birth Control: Understanding the Risks

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

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

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

If you’re over the age of 35 and smoke more than 15 cigarettes per day, the combined pill, patch, or ring can pose a huge risk to your cardiovascular health. Instead, consider the copper IUD, which doesn’t contain estrogen. Alternatively, barrier methods like condoms, diaphragms, and cervical caps are effective and non-hormonal ways to avoid unintended pregnancy, though they don’t provide the added benefits offered by hormonal options.

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.

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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, smoking and using birth control at the same time can lead to a greater risk of cardiovascular issues like strokes or heart attacks.

If you’re a smoker and a user of birth control, read on to learn about how smoking affects various methods of contraception.

cigarrete

What happens if you smoke while taking birth control?

On average, women who smoke die seven years earlier than women who don’t smoke. For women who take birth control, the adverse health effects of smoking are even more concerning. 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, helping transport blood to the brain and other vital 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 conditions are also potential side effects of common hormonal birth control, like the combined pill, patch, and ring. While birth control pills can increase the risk of blood clots by three- to four-fold, the overall risk is minimal, with only 1 in 3000 women who take birth control going on to develop a blood clot.

This risk is raised significantly when combined with smoking. Women aged 35 and up who smoke have the highest risk of experiencing cardiovascular side effects from birth control. If you’re older than 35 and smoke, starting hormonal birth control without informing your doctor that you’re a smoker can seriously damage your cardiovascular health. Be sure to inform them of your smoking history when discussing birth control options, as they may recommend an alternative.

woman vaping

Is it safe to vape on birth control?

Although vaping has been marketed to help people quit smoking, the FDA hasn’t approved it as a legitimate smoking cessation device. But does vaping carry the same risks as smoking when combined with birth control?

While there are nine million adults in the U.S. who vape, it’s relatively new to the market, and there are very few studies on the effects of vaping and birth control.

However, nicotine, the active ingredient in vaping products and cigarettes, is known to increase the risk of blood clots and adversely impact the cardiovascular system of people who take birth control. Despite the lack of definitive studies into the effects of vaping while taking hormonal contraception, it’s safe to assume that it should be avoided.

 

How can Pandia Health help? 

At Pandia Health, we take pride in prescribing birth control based on several factors, including age, ethnicity, BMI, and general health — including whether or not you smoke.

All these factors can influence your body’s reaction to birth control, which your doctor will take into account when reviewing the best options for you.

With just one $30 payment a year, you can get access to our expert doctors (available in these states) for 364 days. To change your birth control, contact us today!

birth control pill

Conclusion

Tobacco and nicotine are highly addictive, making it difficult for many to quit smoking. 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.

The majority of women surveyed were unaware that there are safe alternatives for smokers. In many cases, women aren’t aware of the dangers associated with smoking while using hormonal contraceptives. Other surveys have indicated that up to half of all women who got a prescription for birth control didn’t inform their doctors of their smoking habits.

Pandia Health is here to help you find a birth control method that’s safe and effective for you, regardless of your smoking habits and reasons for using birth control. Sign up to Pandia Health today to get access to our knowledgeable, helpful doctors and FREE delivery of your birth control directly to your home.

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.

Frequently Asked Questions

Can you use cannabis while on birth control?

Most likely yes. Some studies have shown that THC elevates blood pressure temporarily and when combined with estrogen-containing birth control which can also raise blood pressure, 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?

Yes. The IUDs (both copper and hormonal) are highly effective and can be used safely by women who smoke . If you're a smoker, our doctors recommend for your general health and to decrease cancer risk (of all kinds, lung, cervical, etc.) to quit smoking or cut down if you can’t quit.

How long after quitting smoking can I use birth control?

Depends on your age. If you are under 35, you could start immediately. If you are 35 or older, some might recommend former-smokers use progestin-only birth control (pills, implant, IUD, shot) until you quit smoking for an entire year. In general, it takes about 12 months for heart risks associated with smoking to be cut 50% after you quit smoking. However, you could probably start estrogen-containing birth control sooner depending on age and how much you smoked, just know there are increased risks of blood clots and discuss/mention this to your doctor.

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

Yes, if you are on estrogen containing birth control pills. The risk of blood clots or cardiovascular issues from taking birth control pills alone is very low like 1/ 1000 women. However, if you have a family history of blood clots, please tell your doctor before they prescribe you any medication and especially birth control.

How does estrogen increase the risk of blood clots?

Estrogen increases 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 because estrogen levels rise during pregnancy. Birth control pill users have a 1/1000 risk of blood clots vs those not on hormones of 0.3/1000.

Can you vape on birth control?

As of Dec 2022, there is a lack of research in this area. Vaping probably should be avoided while taking combination oral contraceptives as well as the patch, the ring, or injections because it might increase the risk of blood clots like smoking cigarettes because vaping is nicotine.

Does nicotine affect birth control?

Nicotine increases the risk of blood clots and adversely impacts the cardiovascular system of someone who takes estrogen-containing birth control. Nicotine does not affect the ability of birth control to work.

Can you smoke after taking plan B?

Smoking will not affect the results of the Plan B and its generics = Emergency Contraceptive.

Does weed affect birth control?

Studies have shown that THC, a substance found in Cannabis, elevates blood pressure and maybe the risk of blood clots. Estrogen-containing birth control can also contribute to blood clots, thus if combined estrogen-containing birth control pills and THC can increase the risks of blood clots even more.

Why is it bad to smoke while on birth control?

Short answer: smoking while using birth control can lead to a greater risk of cardiovascular issues such as blood clots, 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. The estrogen in the pill increases the risk of blood clots and thus death (the risk is low at 1/1000). So the combination of estrogen and chemicals in tobacco puts you at higher risk of health problems.

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