The short explanation
Yes, it is a good idea to talk to your doctor about changing. Smoking and being over 35 together significantly increase the risk of heart attack, stroke and blood clots for women taking the combined pill, which contains oestrogen. Most guidelines advise that women over 35 who smoke should not use the combined pill. There are many effective alternatives without oestrogen, such as the progestogen-only pill, the hormonal IUD, the Copper T, the implant and the injection. Your doctor can help you choose. Quitting smoking also greatly lowers your risk of heart disease and stroke, whatever method you use.
What depends on your situation
The parts of this that change from woman to woman. Uncertainty is stated, not hidden.
- Do not stop the pill without starting another method, or you could become pregnant.
- Support to quit smoking is available through doctors and national quitlines.
- Your doctor may also check your blood pressure and other heart risk factors.
- Once you have stopped smoking for a year, your options may change; ask your doctor.
What this answer cannot determine
The boundary of online education. These need a clinician who can see you.
- This answer cannot tell which method is right for you. Your doctor can advise based on your health.
Questions for your clinician
Take these with you. You can add any of them to an appointment card.
- Should I stop the combined pill because I smoke?
- Which method should I switch to?
- Can you help me quit smoking?
- Should my blood pressure be checked?
When to seek help
Clinician-approved guidance for this topic. When in doubt, being seen is never the wrong choice.
Emergency — call 112 now
- Call 112 or go to the nearest emergency department if you have chest pain, sudden breathlessness, a painful swollen leg, or signs of stroke.
Book an appointment soon
- See your doctor within a few weeks to discuss switching methods.
Raise it at a routine appointment
- Book routine checks for blood pressure and heart health.
Sources
The evidence this explanation is built on.
Who wrote and reviewed this
Every AskHer answer names its author. A clinically reviewed answer also names the clinician who signed it off — if no clinician is named below, it has not been clinically reviewed.
- Author
- AskHer Editorial (AI-assisted draft) AskHer's editorial team — not an individual clinician Works in English, தமிழ், हिन्दी
- Clinical reviewer
- Nobody yet No clinician has signed this answer off, and no person on the editorial team has read it yet. That is what the “Written with AI assistance” label means. It is queued for an editor to read, and then for a clinician who works in this area. The sources it was drafted against are listed above.
- Review status
- Written with AI assistance — not yet reviewed by a person
- Last reviewed
- Not yet reviewed by a person
- Version
- 1
Correction history
Substantive changes are listed, not quietly edited away.
No corrections have been made since this answer was first published.
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