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To the Editor.—
The articles published in the May 24/31 issue of The Journal on smoking and delayed conception were excellent. I am writing to mention one further confounding variable that should be considered. It is my personal observation that teenage girls between the ages of 13 and 16 years who smoke almost always need birth control. I have never found an exception to this rule in my practice. Girls who are experimenting sexually at an early age are also at a much higher risk for pelvic inflammatory disease and resulting infertility.
Warren ES. Sex and the Smoking Girl. JAMA. 1986;255(1):36. doi:10.1001/jama.1986.03370010038012