The combination of smoking and hormonal birth control may increase the risk of cardiovascular conditions, including high blood pressure, blood clots, and stroke.
Smoking can damage the heart and blood vessels and is a risk factor for cardiovascular disease (CVD). Using hormonal birth control that contains estrogen may also increase the risk of CVD.
This article looks at the risks of smoking and birth control, which types of birth control may be safer to use while smoking, and tips for quitting smoking.
Smoking cigarettes while taking hormonal birth control can increase the risk of cardiovascular conditions.
Which types of birth control?
According to a
Third generation oral contraceptives include:
- desogestrel (Gedarel, Marvelon, and Mercilon)
- gestodene (Femodene)
- drospirenone (Eloine, Lucette, Yasmin, Yacella, and Yiznell)
- norelgestromin (Evra)
- estonogestrel (Nuvaring)
Combined hormonal contraceptives contain estrogen in the form of ethinyl estradiol. Ethinyl estradiol increases blood pressure, blood levels of cholesterol and fats, and the risk of blood clots. Therefore, it
Non-oral hormonal contraceptives, including birth control patches, vaginal rings, and injections, may have a similar risk to combined oral contraceptives.
Combined hormonal contraceptives
There is less research around the effects of progestin-only contraceptives on cardiovascular health. These contraceptives include:
- progestin-only pills
- levonorgestrel-releasing intrauterine device (IUD)
- subdermal implant
- injectable depot medroxyprogesterone acetate (DMPA)
Although progestin content can vary in each form of contraceptive, progestin-only contraceptives generally do not have the same risk of blood clots as estrogen contraceptives.
Progestin-only contraceptives do not affect blood pressure. However, in people with high blood pressure, the DMPA injection may
The risks of smoking tobacco while using hormonal birth control may increase with age.
Those who smoke about 1 cigarette per day may have about half the risk of coronary heart disease and stroke as those who smoke 20 cigarettes per day. However, the researchers state that there is a risk of CVD with any level of smoking.
This suggests that any amount of smoking in combination with hormonal contraceptives may increase the risk of cardiovascular conditions.
There is little research on the long-term health effects of cigarette alternatives such as e-cigarettes and vaping devices.
E-cigarettes may cause inflammation in the lungs and possibly in the cardiovascular system. Both inflammation and oxidative stress may increase the risk of plaque buildup in the arteries.
These effects may be due to nicotine, but researchers need to investigate further.
Currently, there is not enough research to know the effects of e-cigarettes in combination with hormonal birth control.
There is currently not enough research to know the health effects of cannabis use alongside hormonal birth control.
Cannabis use may have associations with diseases of the arteries, although researchers need further evidence.
The AHA concluded that there is currently not enough research on the effects of marijuana in people with cardiac risk factors.
According to the
Smoking hookah may cause a greater intake of smoke than smoking cigarettes. This may increase the absorption of toxic substances.
Since hookah and tobacco cigarettes contain many of the same substances and can pose similar cardiovascular risks, smoking hookah in combination with estrogen contraceptives may have the same risks as smoking cigarettes.
Nonhormonal birth control and progestin-only contraceptives
Alternative birth control options include:
People can consult a healthcare professional to determine the most suitable form of birth control for them.
There is little recent evidence on whether smoking changes the effectiveness of birth control pills.
Although some older research has suggested that smoking may reduce the effectiveness of birth control and that nicotine may affect estrogen levels, there is no conclusive evidence.
To successfully quit smoking, it is important for people to be mentally ready to do so. This is because a person will need to overcome a physical addiction to nicotine as well as the habit of smoking.
When people feel ready and able to quit smoking, the following tips may help:
- Be clear on the reason for quitting and use it as motivation.
- If possible, choose to quit during a stress-free time period, and make a quitting plan.
- Ask for support from family, friends, and colleagues.
- Replace smoking with healthier activities.
- Exercise each day.
- Get quality sleep and rest.
- Eat a balanced diet.
- Join a support group or cessation program.
People can make a quitting plan using this online tool.
Medications, including bupropion and varenicline, are available to help people quit smoking. These medications may not be suitable for everyone, so people should speak with a doctor about their potential options.
Smoking is a risk factor for CVD. Combined hormonal birth control may also increase the risk of CVD.
People who are using hormonal birth control and have additional CVD risk factors, such as smoking, may have an increased risk of cardiovascular problems. This risk may increase for people older than 35.
Nonhormonal birth control methods — such as condoms or the copper IUD — or progestin-only birth control pills may be safer options for people who smoke.
People can discuss contraceptive methods and their smoking habits with a healthcare professional in order to find the safest and most effective birth control option for them.