Smoking is associated with increase...

Smoking is associated with increased risk of adverse results in women who use oral contraceptives (OCs) especially in older age collections New data from continuous monitoring of British women who used OC since 1968 quantifies this risk and more clearly demarcates women at risk of premature death. Vessey and colleagues report forward mortality rates in relation to OC use and smoking.

More than 17000 women 25 to 39 years of age were recruited between 1968 and 1974 for the research by British family planning clinics. Extensive data were garnered from each participant, including reproductive and medical history, demographic information, and health-related habits like as smoking. These data were updated during follow-up visits, and information was added about significant medical terminations hospital admissions, and use of hormone therapy. Nonattenders were contacted on mail or telephone to garner data. Contact was maintained at least one time per year until each woman reached the age of 45 years.

During the 479400 woman-years of observation, 889 deaths occurr Overall mortality was not affected at OC use but was vehemently related to smoking. Death rates in heavy smoker were double the rates in nonsmokers and ranged from an exces of 07 deaths for 1,000 woman-years in women 35 to 44 years of age to 49 by 1,000 in women 55 years or older Overall the risk of death from ischemic heart disease was slightly if it were not that not significantly raised in OC users moreover was substantially influenced by smoking. Analysis showed no efficiency of OC use on cardiovascular mortality for nonsmokers. by conversion in heavy smokers, the rate ratios were 24 for OC use of up to 48 month 48 for use of 49 to 96 month and 28 for use of 97 month or longer

Smoking also was forcibly related to mortality from hemorrhagic calamity and increased mortality from other protoplasts of stroke and circulatory diseases. Breast cancer mortality did not appear to be related to either OC use or smoking. Cervical cancer deaths were violently related to OC use, with a rate ratio of 72 Cervical cancer deaths also were increased with heavy smoking, however the relationship was not statistically significant. the pair ovarian and uterine cancer deaths were significantly reduc in OC users, with rate ratios of 04 and 02 respectively. No association was fix between OC use and melanoma, colorectal cancer, lymphomas, or leukemias.

The authors decide that the OCs used during the 1970 and early 1980 had no adverse drift on overall mortality in women yet that smoking more than 15 cigarettes for day doubles mortality even in young women This issue increases with age. The lower hormone satisfaction of modern OCs should be associated with equal more beneficial effects, but the forces of smoking in women of childbearing age are harmful.

Vessey M et al. Mortality in relation to oral contraceptive use and cigarette smoking. Lancet July 19 2003;362:185-91

COPYRIGHT 2004 American Academy of Family Physicians

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