Dear Alice,

My question is this; does smoking marijuana have the same effects as smoking cigarettes if you're on the birth control pill? Thanks.

Dear Reader,

You pose an important and challenging question. Research shows smoking marijuana affects the cardiovascular system in similar ways as smoking tobacco. And, research suggests that smoking tobacco while on hormonal birth control ups the risk of cardiovascular problems. Based on this logic it might be reasonable to predict that smoking marijuana while on the pill would increase cardiac risks as well.

Yet, this line of reasoning isn't confirmed by data. Marijuana research is tightly regulated, because it is an illegal drug, meaning that due to the lack of research there isn't a solid answer to your question about the effects of smoking marijuana when combined with birth control pills. However, it may be useful to look at the similarities between marijuana and cigarettes a little further.

The short-term effects of both substances include increased blood pressure and heart rate. Although sporadic marijuana use hasn't been linked with negative long-term effects in young, healthy users, long-term outcomes in chronic heavy users may be similar to effects of tobacco smoking. These long-term effects include increased risk for stroke, heart attack, and cancer. Also, marijuana and tobacco smokers tend to have a lower tolerance for exercise than non-smokers. Neither tobacco nor marijuana is associated with decreased effectiveness of birth control pills.

As your question suggested, smoking tobacco while on a birth control pill is not recommended. The World Health Organization estimates that women who smoke tobacco while on the pill are twenty times more likely to develop heart disease than non-smokers. Risk of coronary heart disease and stroke increases with age and amount of tobacco smoked.

More research would be helpful to aid women who are on the pill in their decisions about smoking marijuana. In the meantime, you may wish to consider the similarities between the effects of smoking marijuana and tobacco on the cardiovascular system along with what is known about the dangers of mixing tobacco with the pill.


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