Vaping and birth control: Too risky to go together

Know the risks
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Vapes, also known as e-cigarettes, are all the rage in the smoking world, especially among young people. According to the 2021 National Youth Tobacco Survey, more than 2 million U.S. teens are vaping. This rise in teens smoking e-cigarettes is especially concerning amidst the backdrop of widespread hormonal birth control use. An estimated 25% of teen girls are on some form of hormonal birth control. Here, we’ll discuss the unique risks vaping poses for women on birth control.

Birth control risks

Natural Womanhood frequently discusses the many risks and side effects of hormonal birth control (HBC). When it comes to vaping and birth control, it’s important to know that, on its own, HBC use already increases women’s risks for:

  • Mood disorders (like depression and anxiety)
  • Heart attack
  • Stroke
  • Blood clots
  • Pulmonary embolism
  • Various cancers (chiefly breast and cervical)

Vaping risks

The rise in vaping has been attributed to its marketing as being “safer” than traditional cigarettes. However, this may not be the case. The primary ingredient in e-cigarettes is nicotine, which is highly addictive and increases risk of heart problems and blood pressure spikes. Research suggests that vapes may be more addictive than traditional cigarettes [1]. 

Hopkins Medicine noted that there are thousands of potentially harmful chemical ingredients in e-cigarettes. These chemicals are often unlisted and have not been approved for safe use. Additionally, recent studies suggest a link between vaping and chronic lung diseases and asthma. 

We know that smoking nicotine products like cigarettes increases one’s risk for cardiovascular problems, and cancer in the lungs, throat, mouth, pancreas, bladder, and cervix. It is possible that because vapes also contain nicotine that they may have similar effects, although more research is needed. What’s more, nicotine-containing products aren’t an equal opportunity offender: according to a literature review published in Nicotine and Tobacco Research, women are “more susceptible [than men] to the harmful effects of smoking” [2].

General risks for smokers who use hormonal birth control

We have previously addressed the increased risk of cardiovascular problems for women on HBC who smoke. Smoking, in part because of the primary ingredient nicotine, thickens the blood and increases blood pressure and heart rate. When you combine these effects with HBC use, your risk for stroke, blood clots, and heart attack goes even higher. In a VeryWell Health article about the risks of smoking while on birth control, Dr. Geralyn Dexter points out that the combination pill poses an added risk because of the synthetic estrogen it contains.This in turn significantly raises cardiovascular risk for female smokers, and even more so for female smokers over age 35. Additionally, nicotine can impact the effectiveness of HBC.

A 2019 literature review from the Journal of Nicotine and Tobacco Research also found that HBC use combined with smoking is associated with faster nicotine metabolism [2]. This means women using both HBC and nicotine-containing products will have increased nicotine cravings and withdrawal symptoms, leading them to smoke more. They will likewise have a harder time stopping smoking

What are the combined risks of birth control and vapes?

We’ve established that vaping and birth control can each cause their own set of health problems. Because of the popularity of both, especially among young people, it is worth considering the risks posed to women who are using them together. While more research is needed to determine the nature and degree of their combined risk, according to Relay, an addiction recovery app, vaping while on HBC results in a drug interaction that increases the risks of both products. One specific increased risk is blood clot formation, especially in the legs and lungs. 

We previously highlighted the fact that women who are on birth control and regularly use over-the-counter pain relievers have a much higher risk of blood clots than women who just use pain relievers or who just use birth control. The two work synergistically to increase blood clot risk. Given what we know about the interactions between nicotine and hormonal birth control (especially estrogen-containing birth control) the same may be true of vaping and birth control. However, we need more research to know whether the risk is a simple addition problem (risk of birth control + risk of vaping = total risk) or whether it multiplies, even exponentially. While there’s plenty we don’t yet know, what we do know tells us that vaping and hormonal birth control are probably too risky to go together.

What can I do to lower my risk?

If you are currently a vape and HBC user but are uncomfortable with the risk of health problems, nicotine replacement therapy (NRT) could be a viable option. While you’re making positive life changes that benefit your overall health, also look into swapping out HBC for a health-friendly, evidence-based fertility awareness method (FAM) for family planning. And if you’re on HBC for a health problem like irregular periods or heavy bleeding, get in touch with a doctor who specializes in restorative reproductive medicine (RRM) to treat the root cause(s) of your symptoms.  

Additional Reading:

What medications interfere with birth control?

Birth control might make it harder to quit smoking

References:

[1] Jankowski M, Krzystanek M, Zejda JE, Majek P, Lubanski J, Lawson JA, Brozek G. E-Cigarettes are More Addictive than Traditional Cigarettes-A Study in Highly Educated Young People. Int J Environ Res Public Health. 2019 Jun 27;16(13):2279. doi: 10.3390/ijerph16132279. PMID: 31252671; PMCID: PMC6651627.

[2] Alicia M Allen, Andrea H Weinberger, Reagan R Wetherill, Carol L Howe, Sherry A McKee, Oral Contraceptives and Cigarette Smoking: A Review of the Literature and Future Directions, Nicotine & Tobacco Research, Volume 21, Issue 5, May 2019, Pages 592–601, https://doi.org/10.1093/ntr/ntx258

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