While many use birth control as a safe and effective tool to help prevent pregnancy, what is less known is that certain forms of contraception come with serious side effects when mingled with risk factors like nicotine.
People who smoke cigarettes, use e-cigarettes, use nicotine replacement therapy products, or who may be just curious about the adverse link between nicotine and birth control need to beware of the potential consequences.
This article will explore how nicotine affects birth control and the possible risks and side effects associated with this combination.
Nicotine and Birth Control
Some studies examining the association between nicotine and birth control found that smoking while taking oral contraceptives could increase nicotine metabolism and the body’s stress response.
The combination birth control pill contains the hormones estrogen and progestin.
Increased estrogen levels can cause changes in your blood, which heightens the risk of getting blood clots. 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 people who take birth control developing a blood clot.
The Effects of Nicotine
Some harmful effects of nicotine include:
- Psychoactive effects
- Compulsive use
- Quick relapse
- Drug-reinforced behavior
- Physical dependence
However, nicotine also has adverse effects on all bodily systems.
While some of these develop over time, others can happen quickly.
Nicotine effects on the central nervous system:
- Abnormal sleep disturbances
- Blood-flow risk
Nicotine effects on the cardiovascular system:
- Aortic enlargement and dissection
- Increased clotting
- Heart rate fluctuation
- Increased blood pressure
- Coronary artery disease
Nicotine effects on the respiratory system:
- Shortness of breath
- Chronic obstructive pulmonary disease
Nicotine effects on the muscular system:
- Spinal disc degeneration
- Joint pain
Nicotine effects on the gastrointestinal system:
There are different ways people consume nicotine.
While some traditional smoking may be very harmful, vaping appears less harmful.
Vaping vs. Cigarettes
Vaping is a newer method of smoking that involves inhaling vapor created by electronic cigarettes or other vaping devices.
The device heats up the liquid to produce the vapor inhaled. Vaping is now a common method of consuming nicotine.
Vaping is considered less harmful than smoking because it exposes users to fewer toxic chemicals than smoking traditional cigarettes.
According to a report from the Centers for Disease Control (CDC), people who smoke cigarettes and are over 35 years old should not use combined hormonal birth control methods like combination birth control pills, the patch, and the ring.
Research suggests that smoking cigarettes while taking oral contraceptives can increase your risk of serious cardiovascular side effects, such as stroke, heart attack (myocardial infarction), and blood clots (venous thromboembolism).
The American College of Obstetricians and Gynecologists (ACOG) has also weighed in here, advising doctors to prescribe combination oral contraceptives with caution (if at all) for people with vaginas who are older than 35 years and smoke.
The common ingredient between cigarettes and vapes is nicotine.
Therefore, when considering the risks smoking cigarettes pose while taking birth control—such as the increased risk of heart problems, blood clots, and stroke—and factoring in the same main ingredient with vapes, vapes may cause similar issues.
The nicotine patch provides a steady, controlled dose of nicotine throughout the day, thereby reducing the effects of nicotine withdrawal.
Patch strength is reduced over time, allowing the person to wean themselves off of nicotine gradually.
The nicotine patch resembles a square beige or clear bandage. The size depends on the dose and brand but generally is between 1 and 2 inches square.
The nicotine patch should be applied once daily to clean, dry, hairless skin. Manufacturers usually recommend wearing the patch between 16 and 24 hours a day, depending on what you’re comfortable with.
Smoking Cessation Aids
Smoking cessation products are intended to help you quit smoking.
They are regulated through the FDA’s Center for Drug Evaluation and Research, which ensures that the products are safe and effective and that their benefits outweigh any known associated risks.
The FDA has also approved several smoking cessation products designed to help gradually withdraw smoking by using specific amounts of nicotine that decrease over time.
This type of product is called a “nicotine replacement therapy” or NRT. Some over-the-counter NRTs approved for sale include:
- Skin Patches: Also known as transdermal nicotine patches, these patches are available over the counter and by prescription. These patches are placed on the skin, similar to applying an adhesive bandage.
- Chewing Gum or Nicotine Gum: These products come in various flavors and are designed to be chewed according to the label instructions to be effective.
- Nicotine Lozenges: Lozenges come in various flavors and are consumed by dissolving them in the mouth.
Some other products include:
- Inhalers: These include a nicotine cartridge and work like an asthma inhaler. The nicotine enters your bloodstream as it’s absorbed through your mouth and throat lining.
- Nasal Sprays: The nicotine nasal spray delivers a solution that contains a small dose of nicotine into your nostrils. The nicotine enters your body by being absorbed through the lining of your nose.
- Bupropion SR (Zyban): Bupropion is a prescription medication classified as a type of antidepressant. An extended-release form of bupropion is approved to help people stop smoking. Bupropion is thought to decrease tobacco cravings and withdrawal symptoms by increasing the levels of certain brain chemicals.
- Varenicline tartrate (Chantix): Varenicline is a prescription medication that can help reduce cravings for tobacco and control nicotine withdrawal symptoms. It also blocks nicotine receptors in your brain, which decreases the pleasurable effects of smoking.
It is important to consult with a health professional before starting any smoking cessation product.
Understanding the Risks
When you combine the effects of nicotine with those of birth control pills, you have an increased chance of stroke and heart attack.
That’s because nicotine causes blood pressure to rise and heart rate to accelerate. The pill adds more stress to the blood vessels because of the extra estrogen.
All of these cardiovascular events can be deadly, meaning you have a higher risk of premature death if you smoke while you use birth control.
This is why it is essential that you let your doctor know that you smoke before you start to discuss birth control options.
Starting hormonal birth control without informing your healthcare provider that you’re a smoker could put you at significant risk of damaging your health.
This is particularly important if you’re over 35 years of age.
People aged 35 and up who smoke have the highest risk of experiencing cardiovascular side effects from using birth control.
If you are older than 35 and smoke, your healthcare provider will most likely provide alternative options.
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Frequently Asked Questions
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
ACOG releases guidelines on hormonal contraceptives in women with coexisting medical conditions. (2007).
Contraceptive hormone use and cardiovascular disease. (2019).
Current contraceptive status among women aged 15–49: United States (2017–2019)
Electronic cigarettes for smoking cessation. (2021).
FDA: Want to quit smoking? FDA-approved products can help. (2017).
How smoking and nicotine damage your body. (2015).
Nicotine transdermal patch. (2015).
Oral contraceptives and cigarette smoking: a review of the literature and future directions. (2019).
Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use. (n.d.).
Women's health. (n.d.).