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Birth Control and Nicotine: Is It Safe to Combine Both?

One of the most popular misconceptions is that women who smoke can safely take oral birth control medicine without experiencing any serious side effects. Some also believe that using vape is completely harmless compared to smoking cigarettes if you are on the pill.
woman smoking nicotine birth control

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A study shows that eight out of ten women who are on birth control pill method continue to smoke even after their doctor has informed them of the risks. Some do not disclose their smoking habits to their doctor. There are others who are completely unaware of the effects of birth control and nicotine combined.

It is important to be informed that cigarette smoking and birth control each have associated health risks. Having said that, doing both at the same time can lead to serious side effects that can put your health at risk.

Learn about birth control, smoking or vaping, and the important link between these.

What is Birth Control?

contraception pill

The use of oral contraceptives or birth control pills is a popular birth control method. These pills are medicines that contain hormones for the purpose of preventing pregnancy with a high rate of 99% effectiveness when used perfectly. That means taking it daily at the same time and not missing any dose.

For informational purposes, there are two types of pills: combination pills and progestin-only pills. Combination pills stop ovulation and thicken the cervix to prevent the sperm from reaching the uterus. Progestin-only pills also thicken cervical mucus and then make the lining of the uterus, referred to as the endometrium, thinner so that the fertilized egg won’t implant in the lining. A professional healthcare provider can give medical advice on which birth control medicine is suitable for you.

The Effects of Birth Control on the Body

When taking oral birth control, your hormonal makeup changes. The pills deliver extra estrogen to your system to prevent ovulation and conception. The extra estrogen causes blood thickening, putting you at risk for blood clots.

The other common effects are feeling soreness in the chest area, nausea, headaches, migraines, spotting between periods, mood changes, and decreased libido. Taking birth control can increase long-term risk of certain health issues.


While most people can take oral birth control medicine without experiencing any problems, health care providers do not recommend it for smokers and those with:

  • Hypertension
  • Coronary artery diseases
  • Known or suspected breast cancer or cancer of uterus, cervix, or vagina
  • Unexplained vaginal bleeding
  • Liver tumor
  • Known or suspected pregnancy
  • Uncontrolled high blood pressure
  • Diabetes
  • Lupus
  • Migraines with aura

Oral birth control can put you at risk for:

  • Pulmonary embolism
  • Hypertension (high blood pressure)
  • Deep vein thrombosis (DVT)
  • Heart diseases
  • Heart attacks
  • Stroke
  • Blood clots
  • Liver tumors
  • Death (rare cases)

What is Nicotine?

woman smoking vape

Nicotine is an extremely addictive substance commonly found in cigarettes and vape. It is a stimulant that is considered to be a dangerous neurotoxin. It works by triggering the nervous system to release hormones and neurotransmitters that affects parts of the brain and the body. 

This substance makes smoking addictive as it triggers the release of dopamine, the brain’s “happy” chemical or “happy hormone” which makes the smoker feel happy, excited, stimulated, satisfied, and rewarded. Activating the brain’s reward center will make you want to reach for another smoke.

The Effects of Nicotine on the Body

Smoking does not only affect your lungs, but also your entire body. When you smoke or vape, inhaled cigarette smoke that contains nicotine and other chemicals enter the lungs. And then, enters the bloodstream very quickly. 

As a stimulant, it can increase blood pressure, heart rate, and alertness. It may also decrease or increase your appetite, cause nausea, induce diarrhea, decrease stamina, and lower endurance.

Long-term effects include developing a weak immune system, poor vision, dull sense of taste and smell, and for women, early menopause.


Smoking is considered to be one of the biggest public health threats, and has been linked to a number of diseases:

  • Cancer
  • Cardiovascular disease
  • Stroke
  • Lung diseases
  • Liver diseases
  • Diabetes
  • Chronic Obstructive Pulmonary Disease (COPD) 
  • Chronic bronchitis
  • Tuberculosis 
  • Emphysema
  • Atherosclerosis
  • Fertility problems
  • Eye defects
  • Ulcers
  • Periodontal diseases

Smoking and Birth Control Pills

woman smoking blonde

What happens to the body when you smoke or vape while using hormonal birth control? Remember that each has its associated health risks due to the presence of nicotine in cigarettes and hormones, such as estrogen, in oral contraceptives. It is not recommended to combine both due to the following reasons:

It puts you at risk for blood clots.

Smoking alters the blood by making it thick, which can lead to blood clots in the legs, lungs and veins of the brain. The hormone in birth control multiplies your risk for it by increasing concentrations of clotting factors in the blood. 

It increases your risk for heart attack.

When blood in the blood vessels is thick, blood flow becomes affected. The heart has to work harder to pump blood throughout the body to achieve proper circulation. This adds stress to the heart and also to the blood vessels, putting you at more risk for heart disease and heart attack.

It can lead to stroke.

Stroke, a leading cause of death and disability, happens when blood supply to a part of the brain is interrupted. The use of birth control alone already elevates the risk as it increases blood viscosity. For smokers who are using oral contraceptives, the risk becomes double because chemicals in cigarettes cause narrowing of the blood vessels, which restricts blood flow.

What can smokers on birth control do? 

It is recommended to stop smoking as soon as possible to reduce the risk for serious complications. If it is not an option, seek medical advice from your doctor or healthcare provider, and search for other birth control methods such as male and female condoms, cervical cap, intrauterine devices, and sterilization.

Alternatives to Quit Smoking or Vaping

Breaking the habit of smoking can be challenging, but it is essential to your overall health and wellness, and if you want to continue taking birth control. Here are methods that you can try:

  • Engaging in physical activities such as swimming, jogging, or running to distract you from cravings. 
  • Practicing relaxation techniques such as yoga and meditation.
  • Eating certain food types that will help you control your cravings: dairy products such as milk, yoghurt, and cheese, and vegetables. Avoid alcoholic and caffeinated drinks.
  • Using a hypnosis app that you can download. It has a proven hypnosis program that is easy to follow and can be combined with complimentary therapy or counseling sessions.

Frequently Asked Questions

Can you take birth control medicine while smoking?

Oral birth control and smoking is described to be a lethal combination.  Doctors do not recommend women to take pills while smoking due to serious risks such as cardiovascular diseases and hypertension. 

Is vaping a safer alternative to smoking while on oral birth control?

No, it is not. Vaping liquids still contain nicotine, so it is not a safer alternative to cigarettes.

What should you do if you are a smoker taking birth control?

The best and safest thing that women who smoke can do while on birth control is quitting smoking. This will help you avoid the combined dangerous health complications.

Consult your doctor as soon as possible for proper medical advice and to help you search for alternate forms of birth control options and/or smoking cessation methods.

I’m trying to quit smoking using patches, but I also want to take oral birth control. What is a good alternative to quit smoking?

Nicotine patches deliver a steady dose of nicotine to the body over a number of hours. When combined with birth control, it can still lead to a serious health risk. It is best to try other methods to quit smoking such as meditation and hypnosis.

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