Hello, in regard to your query whether it is safe to smoke while you are on a pill. If you are above the age of 35 years, the risks are greater like stroke and heart attack, risk of blood clots, where as if you are under 35, the risk will be there but much lesser in comparison. Smoking is associated with lung cancer, cervical cancer, heart disease, mouth or throat or pancreas cancer, recurrence of genital warts, early menopause .If you are socializing then the chances of addiction will be more. Whether you smoke one or two cigarettes a day effect will be the same. It may give you headache, dizziness, and breast tenderness. Birth control pills and smoking have an adverse effect on each other. It would be best to stay away from smoking as it increases your chances to heart attacks, and it aggravates as one gets older. It also causes increase in heart rate and blood pressure. It doesn't matter whether you are on a high dose or a low dose pill, if there is any family history of blood pressure; high cholesterol or heart disease risks are much greater. I would suggest you discontinue the use of tobacco while on the pill to prevent risks associated with it. Thank you.