Smoking and oral contraceptive continuation

Westhoff, Carolyn; Jones, Kandice; Robilotto, Christina; Heartwell, Stephen; Edwards, Sharon; Zieman, Mimi; Cushman, Linda

doi:10.1016/j.contraception.2008.12.003

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Volume 79, Issue 5 , Pages 375-378, May 2009

Smoking and oral contraceptive continuation☆

Carolyn Westhoff
- Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
- Corresponding author. Columbia University Medical Center, 622 West 168th Street, PH 16-69, New York, NY 10032, USA. Tel.: +1 212 305 4805; fax: +1 212 305 6438.
Kandice Jones
- The Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY 10029, USA
Christina Robilotto
- Department of Obstetrics and Gynecology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
Stephen Heartwell
- Domestic Programs, The Susan Thompson Buffett Foundation, Omaha, NE 68131, USA
Sharon Edwards
- Department of Pediatrics, Mount Sinai School of Medicine, New York, NY10029, USA
Mimi Zieman
- Department of Obstetrics and Gynecology, Emory University, Atlanta, GA 30322, USA
Linda Cushman
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA

Received 20 May 2008; received in revised form 11 December 2008; accepted 12 December 2008. published online 29 January 2009.

Abstract

Background

Smoking may be related to early discontinuation of oral contraceptives (OC).

Study design

This was a planned secondary analysis of a randomized clinical trial. Women aged less than 25 initiating OC at three inner-city publicly funded family planning clinics enrolled in the study. Subjects reported smoking status at enrollment; 3- and 6-month interviews assessed OC continuation.

Results

One hundred eighty-nine (12%) of 1598 participants were current smokers. Smokers were more often lost to follow-up than nonsmokers (P<.01). Among participants with a 6-month interview, only 26% of smokers and 46% of nonsmokers were continuing OC (P<.001). After adjustment for confounding factors, smokers were still somewhat less likely to be continuing OC (adjusted OR 0.6, 95% CI 0.4–1.0). This association was unrelated to number of cigarettes smoked per day.

Conclusions

These data suggest that young smokers may be more likely to discontinue OC within 6 months than nonsmokers. Smoking may be a marker for risk-taking behavior that extends to the premature discontinuation of OC.

Keywords: Oral contraceptives, Continuation, Smoking