Format

Send to

Choose Destination
Am J Obstet Gynecol. 1999 Jun;180(6 Pt 2):S383-4.

Oral contraceptives and smoking, current considerations: recommendations of a consensus panel.

Author information

1
Department of Obstetrics and Gynecology, Harvard Medical School, the Division of Hematology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Abstract

In a closed meeting, members of the consensus panel evaluated the presentations of the scientific panel and developed a series of recommendations. They outlined clinical imperatives related to the identification and education of patients who smoke, the physician's role in smoking cessation, and the prescription of oral contraceptives for patients who smoke. They also outlined research objectives for the future. The most important suggestions include the following: All patients should be asked about their smoking status at every visit, and all smokers should be encouraged and helped to quit. The decision to prescribe an oral contraceptive requires a detailed personal and family history of thrombotic disease. Measurement of lipid profile should be considered, along with exercise and dietary intervention, for smokers >35 years old who use or request oral contraceptives. Patients >35 years old who smoke heavily (>15 cigarettes/d) should be denied the use of oral contraceptives. Preliminary data suggest that an oral contraceptive with the very low dose of 20 micrograms ethinyl estradiol may be safer for oral contraceptive users who smoke, even for those >35 years old who have an occasional cigarette, but these laboratory findings require clinical corroboration.

PIP:

This article summarizes the activities of a conference in Montreal, Canada, entitled "Oral Contraceptives and Smoking: Current Considerations." Members of the consensus panel evaluated the presentations of the scientific panel and developed a series of recommendations. The clinical imperatives related to the identification and education of patients who smoke, physicians┬┐ role in smoking cessation, and prescription of OCs for patients who smoke were elaborated. The following recommendations were made: 1) encourage patients who smoke to quit smoking; 2) counsel patients regarding OC benefits; furthermore, counsel patients concerning the risks of concomitant smoking and OC use; and 3) prescribe 20 mcg ethinyl estradiol for women who smoke. In view of the remaining unanswered questions, the panel outlined several research objectives for the future.

PMID:
10368525
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center