Feature Archive

Smoking and the Pill

WebMD Feature

June 5, 2000 -- As a rebellious teenager growing up in Berkeley, Calif., Sandra Thompson (not her real name) didn't think twice about lying to her doctor about a pack-a-day smoking habit to get her hands on birth control pills. Now a doctor herself, Thompson, 30, is much more careful about mixing cigarettes and oral contraceptives. "At one point, it was a real driving force for me," she says. "I knew I had to either quit the pill or quit smoking." She quit taking the pill.

Thompson's dilemma is familiar to many female smokers. Oral contraceptives are the most popular reversible form of birth control in America, yet smokers must decide if the protection is worth the risk. The pill works by providing a steady dose of synthetic hormones that prevent ovulation. For nonsmokers, problems associated with the pill are minimal. For women who smoke, however, the dangers include potentially fatal blood clots, heart attack, and stroke -- especially for women 35 and over.

This year, as the pill celebrates its 40th birthday, smokers may finally have reason to celebrate. According to a study published in the January 1999 issue of the journal Obstetrics & Gynecology, newer low-dose versions of the pill may be safer for smokers than older versions of the contraceptive. The study looked specifically at progesterones, which have been problematic for smokers' hearts in the past. "What we found is that a lot of medical literature was based on old formulations of oral contraceptives," says Patricia Straneva, lead author of the study. "There was a need to reconsider the pill for women who smoke."