Jain A K
Am J Obstet Gynecol. 1976 Oct 1;126(3):301-7. doi: 10.1016/0002-9378(76)90539-1.
The excess risk of nonfatal myocardial infarction among users of oral contraceptives observed in England and Wales can be explained in terms of the high proportion of smokers in the study population. Among nonsmokers, the relative risk associated with the use of oral contraceptives is estimated to be 2 to 1, which is not statistically significant (P = 0.28, Fisher's exact probability test). The present analysis suggests that smoking be considered as another contraindication for the prescription of oral contraceptives. The results further indicate that those women who smoke as well as use oral contraceptives and are interested in reducing the risk of nonfatal mycardial infarction should be encouraged to give up smoking. The relative risk of nonfatal myocardial infarction associated with the use of oral contraceptives observed in a society can vary between 0.9 to 1 and 11.7 to 1, depending upon the proportion of smokers. From the public health point of view, the reduction in the excess risk of nonfatal myocardial infarction achieved by eliminating smoking is estimated to be much more than can be achieved by eliminating the use of oral contraceptives.
在英格兰和威尔士观察到的口服避孕药使用者中非致命性心肌梗死的额外风险，可以用研究人群中吸烟者的高比例来解释。在不吸烟者中，与使用口服避孕药相关的相对风险估计为2比1，这在统计学上不显著（P = 0.28，费舍尔精确概率检验）。目前的分析表明，吸烟应被视为口服避孕药处方的另一个禁忌症。结果还表明，那些既吸烟又使用口服避孕药且有兴趣降低非致命性心肌梗死风险的女性应被鼓励戒烟。在一个社会中观察到的与使用口服避孕药相关的非致命性心肌梗死的相对风险可能在0.9比1至11.7比1之间变化，这取决于吸烟者的比例。从公共卫生的角度来看，通过消除吸烟实现的非致命性心肌梗死额外风险的降低估计远大于通过消除口服避孕药的使用所能实现的降低。
