not a doctor -- so don't take this in any way as medical advice...but here are the variables I would consider for myself (and I do, because I use the pill) -- how is your blood pressure? how is your A1c? Your blood pressure and your A1c (that shows how glycated your hemoglobin has been over the past month or so and reveals an average blood sugar value) together form a good picture, the best new research shows that the higher your A1c is, the more likely you are to have a cardiovascular event. Personally, I think that the particulate associated with smoking is what really messes up lungs and thereby screws with the cardiovascular system, making your heart work harder. But again, this is my personal observation. I think the doctors dun everyone who smokes, using every excuse they can to try to leverage you to quit. They don't know how nicotine affects hrt or hbc, because they have never done a good study controlling other factors enough to come to any useful conclusions. But even if they don't know, they feel justified in scaring you. So to fold in the effect of nicotine, you need to ask yourself what effect if any the nic has on your blood pressure and blood glucose. YMMV. Just my opinion, but you can google up more detail about all of these factors.