Trends in oral contraceptive use and cigarette smoking. Behavioral Risk Factor Surveillance System, 1982 and 1988
D. H. Barrett, R. F. Anda, L. G. Escobedo, J. B. Croft, D. F. Williamson and J. S. Marks
Cardiovascular Health Studies Branch, Centers for Disease Control and Prevention, Atlanta, Ga.
OBJECTIVE: To investigate trends in oral contraceptive (OC) use and smoking
among women of reproductive age and to determine factors related to smoking
among OC users. DESIGN, SETTING, AND PARTICIPANTS: Telephone interviews of
women aged 18 through 45 years in 16 states and the District of Columbia
who participated in the Behavioral Risk Factor Surveillance System in 1982
(N = 3553) and in 1988 (N = 7384). RESULTS: Between 1982 and 1988, the
prevalence of smoking decreased from 31% to 24% among OC users and from 32%
to 28% among non-OC users. In both 1982 and 1988, more than half of the OC
users who smoked were heavy smokers (smoked 15 or more cigarettes per day).
Nearly one fourth of 35- to 45-year-old women who used OCs were smokers.
After we standardized for age, race, and education, the decline in the
prevalence of smoking among OC users did not differ substantially from the
decline in smoking among non-OC users. CONCLUSIONS: Despite the possible
synergistic effects of smoking and OC use on the risk of cardiovascular
disease, we found no accelerated decline in the prevalence of smoking among
OC users. As of 1988, nearly one fourth of all OC users were smokers. These
data emphasize the need to reduce the prevalence of smoking among women who
use OCs before they reach the age at which their risk for cardiovascular
disease increases substantially.
