Nicotine and birth control: does nicotine affect birth control?

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Birth control isn’t something that many of us are taught to understand in detail during education, despite the important role it plays in many of our lives. 

Often, we’re left to conduct our own research on different options and side effects – and this can be super overwhelming! 

So you may be feeling curious or confused about the impact of lifestyle habits on your birth control – particularly smoking or vaping.

In this blog, we’ll explore the relationship between nicotine and birth control: what it is, how they work together and the risks you should know about.  

But what exactly is nicotine?

Nicotine and birth control

Nicotine is a psychoactive chemical that makes up the main ingredient in tobacco. It’s most often consumed by smoking cigarettes, cigars, or pipes.

Nicotine is a stimulant drug which speeds up the messaging between the body and the brain. 

There’s no safe level of drug use recommended for nicotine because even the smallest amount carries a risk to the body and the brain. 

The overall effects of nicotine depend on a person’s size, weight, and existing health conditions. 

In the short term, side effects can vary depending on a person’s tolerance to nicotine. 

For those with a lower tolerance, the effects may include dizziness, headaches, or nausea. 

For those with higher tolerance – they may feel more stimulated or relaxed, with an increased heart rate, better ability to focus, and a reduced appetite.

Here are a few effects of nicotine you may need to know:

The long term effects of nicotine can have an incredibly damaging impact on the body. It is a major cause of premature death worldwide. 

Potential damage caused by nicotine includes: 

  • Cancer
  • Stroke
  • Blindness
  • Aneurysms
  • Heart disease
  • Diabetes

And many more

The key problem with nicotine is that it’s highly addictive. This makes it difficult for many people to stop smoking even when they recognize the threat it poses to their health

It’s important to understand the risks of nicotine in pregnancy:

risks of nicotine in pregnancy

For fetuses exposed in the womb, the drug can stunt their development and cause them to be born with a lower birth weight than average.

Other complications include: 

  • Premature birth
  • Infant illness, 
  • Ectopic pregnancy
  • Pregnancy loss

Nicotine causes a much higher chance of ectopic pregnancy because it reduces the motility of the reproductive tract. The egg then struggles to make its way along the fallopian tube to the uterus and instead begins to grow in the tube. 

Nicotine is bad news for fertility

bad news for fertility

Nicotine has a negative impact on both female and male fertility. Infertility rates are roughly twice as high in smokers compared to non-smokers. 

Research has suggested that in women, nicotine can decrease the quality of eggs in the ovaries. This makes it more difficult for fertilized embryos to implant in the uterus. 

What about men’s fertility?

Nicotine can decrease the number, motility, and quality of a man’s sperm. It can also damage the blood vessels in the penis. 

This reduces a man’s ability to maintain erections and can cause them to become impotent. 

According to the journal of andrology, men are almost twice as likely to have erectile dysfunction if they smoke. 

So, how does nicotine affect birth control?

It’s well known that nicotine can have a negative impact on fertility – but what about people who are trying to avoid pregnancy by using birth control? 

The important fact here is that smoking can increase the existing risks of taking combined hormonal birth control methods. 

What are combined hormonal birth control methods?

combined hormonal birth control methods

Combined hormonal birth control are methods that use a combination of synthetic estrogen and progesterone hormones. These are the two key hormones that control your menstrual cycle. Examples of combined hormonal birth control methods include the combined pill, the patch, and the vaginal ring.

Many doctors are advised not to prescribe combined birth control methods to anyone who smokes or is over the age of 35.

A report from the Center for Disease Control (CDC) suggests that taking combined birth control whilst smoking can increase your risk of cardiovascular side effects.

 Examples of these include stroke, heart attack, and blood clots. These findings are also supported by the World Health Organization and the American College of Obstetricians and Gynecologists. 

It makes you wonder – should women be subjected to these kinds of risks just to have basic control over their reproduction?

Estrogen and nicotine: bad news for blood pressure

Birth control containing estrogen is always balanced with progesterone, which is why it’s called ‘combined’ birth control. The progesterone stops the estrogen causing excess growth in the womb lining. This growth could potentially lead to abnormalities and in some cases, cancer. The estrogen in combined birth control has the risk of increasing your blood pressure. 

High blood pressure can then lead to serious cardiovascular problems such as stroke, heart attack, and blood clots. For those who smoke, the combined effect of nicotine can double the risk of cardiovascular complications compared to those who don’t smoke.

Other risks of nicotine and combined birth control

Smoking can also impact your menstrual cycle by causing more spotting and bleeding between cycles. It’s thought that nicotine has a negative reaction with estrogen, changing how the uterine lining breaks down. Research found that smokers were 47% more likely to experience spotting than non-smokers. 

Health experts have expressed concern that those who smoke on combined birth control are more likely to become frustrated and stop using their birth control altogether. This heightens the risk of unintended pregnancy among women who smoke. 

Is vaping any different for my health?


Vaping is the use of electronic nicotine delivery systems or e-cigarettes. These are small tools that vaporize nicotine in liquid form to be inhaled alongside other flavored chemicals. E-cigarettes can contain a range of different nicotine levels, from being nicotine-free to having up to 20 mg. 

Vaping has become increasingly popular over the last decade due to the idea that it is less dangerous than smoking. However, the lack of research into the long term impacts of vaping means the effects are not fully understood. E-cigarettes still contain nicotine so the risk to your health is still present, despite the potential of it being lower. 

What about other birth control options?

It’s only combined birth control methods which contain estrogen that pose a risk to those who smoke. Other birth control options that don’t contain estrogen are safe to use whilst smoking. Non-hormonal methods such as condoms, diaphragms, and the copper intrauterine device (IUD) don’t contain any hormones and won’t impact your blood pressure. 

Unlike estrogen, progesterone can be used alone in some birth control methods. These include the progesterone only pill, or ‘mini pill’, the hormonal IUD, the injection, and the implant. The synthetic progesterone (progestins) contained in these birth control methods does not impact your blood pressure or heart rate. This means they’re safe to use if you are someone who smokes. 

What about emergency contraception?

The safety of emergency contraception is not impacted by smoking habits. The emergency contraception pill, sometimes called ‘the morning after pill’ usually contains levonorgestrel or ulipristal acetate. Neither of these compounds will increase the risk of cardiovascular problems. Either the hormonal or the copper IUD can also be used as emergency contraception up to five days after unprotected sex. Neither of these options contain any hormones and again do not pose any added risk to those who smoke. 

What about consuming nicotine later in life?

Nicotine can also cause menopause to begin between 1 and 4 years earlier for women who smoke compared to non-smokers. This is because nicotine speeds up the loss of eggs in the ovaries. It’s believed that once all the eggs have died, they cannot be replaced and menopause will begin.

How does quitting smoking impact my body?

The good news is that stopping smoking is one of the best ways to boost your fertility! It’s advised to think about quitting smoking before you plan on getting pregnant. Once your body begins to recover – the quality of your eggs and womb lining will improve. This will allow fertilized embryos to implant more easily. 

For most people, an ‘all or nothing’ approach to stop smoking can be difficult due to the addictive nature of nicotine. Some doctors suggest that even cutting down slightly can make a big difference to your fertility. 


  • Combined birth control containing estrogen is not recommended to those who smoke. Both nicotine and estrogen can increase blood pressure. This leads to a higher risk of cardiovascular problems such as stroke, heart attack, and blood clots.
  • This risk includes those who vape e-cigarettes due to the presence of nicotine.
  • Non-hormonal and progesterone-only birth control options are safe to use alongside smoking because they do not impact blood pressure or heart rate.
  • Nicotine can have incredibly damaging impacts on your health, particularly fertility, for both men and women.

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