Smoking, let's be clear about it, is never a safe choice. Smoking kills, albeit slowly. If you would like to choose a reliable contraceptive, but want to protect your health as well, quitting smoking and going on the pill is a much safer option than avoiding the birth control pill because you smoke. Smoking and using hormonal birth control like the pill, NuvaRing, depo Provera, or the Mirena coil, increased your chances of cardiovascular problems. In other words, women who smoke and use these contraceptives run a higher risk of having a heart attack, strokes, or other heart disease.
You would also open yourself to an increased risk of blood clots, which can be extremely dangerous. The risks are even higher for women who are older than 35, or those who smoke over 15 cigarettes a day. Apart from the risks, there are also some indications that smoking decreases the effectiveness of the pill.
All in all, there are some difficult considerations smokers have to make. Of course, we'd advise you to quit smoking rather than avoiding hormonal contraceptives. Giving up smoking can be really hard, and many who try to come back to the habit later. Thankfully, there are many support options available to people who are committed to giving up smoking including medications! If you are hoping to quit your smoking habit, discuss your options with your family practice doctor and work on a strategy to ensure that your "last cigarette" really is your last.