Contraceptive Use Among Women Smokers and Nonsmokers in the San Francisco Bay Area

Background. Women smokers were previously reported to be more sexually active but less likely to use contraception than nonsmokers. Differences in contraceptive choices between the two groups were investigated. Methods. Sexually active women, 287 who smoked cigarettes and 263 who did not smoke, were queried about current contraceptive use and demographic, sexual, and reproductive factors. Results. Sexually active smokers were less likely than nonsmokers to use contraceptives, especially oral contraceptives. The deficit of contraceptive use among smokers was most pronounced in women under age 30, black women, single women, women with some college education, nulliparous women, women who reported early age at first intercourse, and women who reported four or more lifetime sexual partners. In contrast, smokers were more than twice as likely as nonsmokers to use sterilization (P = 0.002). Among women over age 30, prevalence of contraceptive use was similar between the two groups. Oral contraceptives were used by fewer smokers than nonsmokers who were under age 24 (P = 0.01), had a high school education or less (P = 0.01), and/or had never been pregnant (P = 0.03). Conclusions. Young, sexually active women who smoked cigarettes were less likely than nonsmokers to have used contraceptives, especially oral contraceptives, while women smokers over age 30 were more likely than nonsmokers to have used sterilization.