Research Article| Volume 19, ISSUE 13, P1399-1403, December 1997

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Smoking and Contraception

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      Efforts by governments and public health bodies largely have been unable to reduce cigarette consumption by Canadians. Women who smoke (29% of women in the reproductive years) have reduced fertility and an increased risk of short-term and long-term cardiovascular disease. Women who have used oral contraceptive preparations in the past appear to have no increased cardiovascular risk, but current users carry an increased risk of thrombosis. The degree of risk is proportional to the estrogen dose of the preparation used. Women who smoke cigarettes and concurrently use oral contraceptives increase their risk of myocardial infarction beyond that of using either agent alone; the risk is increased in heavier smokers and in women over age 35. There is no effect of smoking on other forms of contraception.


      La plupart des efforts déployés par les gouvernements et les organismes de santé publique pour réduire la consommation de cigarettes des Canadiens se sont révélés vains. Les fumeuses (29 % des femmes en âge de procréer) présentent une fertilité réduite et un risque accru de maladie cardiovasculaire à court et à long terme. Dans le passé, les femmes ayant utilisé des préparations contraceptives orales ne semblaient courir aucun risque accru de maladie cardiovasculaire, mais les utilisatrices actuelles présentent un risque accru de thrombose. L’importance du risque est proportionnelle à la teneur en oestrogènes de la préparation utilisée. Les femmes qui fument la cigarette et utilisent simultanément des contraceptifs oraux courent un risque d’infarctus du myocarde plus élevé que si elles n’utilisaient que l’un ou l’autre de ces agents; le risque augmente chez les femmes qui fument beaucoup et chez celles qui ont plus de 35 ans. Le tabagisme est sans effet sur les autres types de contraception.

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