Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

Recent challenges to contraceptive access make the scenario all too easy to imagine: A woman goes to her health care provider to get her annual check-up and to renew her prescription for birth-control pills. She’s been going to the same health center and using the same birth control pills for years, but this time a nurse practitioner refuses to renew her prescription.

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Heavy smoking and use of birth control pills increase risk of a first-time heart attack by a factor of 30.

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The scenario is easy to imagine when we’ve seen the concept of religious liberty stretched beyond its limits. The concept has been used to trump other liberties, to excuse organizations from compliance with health care mandates that ensure access to the contraceptives that many struggle to afford. But the scenario just described is exactly what happened to a woman in Iowa, whose clinic refused to renew her prescription for birth control pills, not because of bills passed by lawmakers, but because of her age, 42, and the fact she smoked. Those two factors made use of birth control pills risky for her — and a liability for her provider.

Today is World No Tobacco Day, so this installment of our “Over 90 Percent” series takes a look at the toll smoking takes on sexual health, and what Planned Parenthood health centers can do to help people quit. The World Health Organization launched World No Tobacco Day in the late 1980s to encourage tobacco users around the world to quit tobacco for at least 24 hours. It has also served as a day to promote other anti-tobacco initiatives and raise awareness about the effects of tobacco use.

When people think of smoking, one of the first health effects that comes to mind is lung cancer — and for good reason. Smoking is the most significant risk factor for lung cancer and causes an estimated 90 percent of lung cancer cases in the United States. However, almost every organ in the body is susceptible to the effects of smoking. The most immediate effects occur in the respiratory, nervous, cardiovascular, immune, gastrointestinal, and metabolic systems.

Smoking also affects sexual health.

In the case of the Iowa woman, her smoking, age, and use of birth control pills were considered a combination that could put her at risk of blood clots. She was a light smoker, so the provider eventually compromised and gave her a 30-day prescription, as long as she signed a waiver of liability. However, had she been a heavy smoker, 25 cigarettes or more each day, it’s likely that the provider wouldn’t have taken that chance. One study found that heavy smoking and use of birth control pills can increase a woman’s risk of a first-time heart attack by a factor of 30, and those findings were true regardless of whether the woman was taking low-dose or high-dose pills. Since both can elevate blood pressure, cigarette smoking and birth control pills can put some women at a greater danger of both heart attack and stroke.

Smoking and tobacco use are associated with a host of other reproductive health disorders as well, including menstrual irregularity, diminished quantity and viability of ova, ectopic pregnancy (fertilized ovum outside of the uterus), miscarriages, lower sperm density, abnormally shaped sperm, and erectile dysfunction. Additionally, survey evidence indicates that smokers have sex less frequently than non-smokers and enjoy sex less.

For smokers and other tobacco users, there are many reasons to quit, and their sexual health is an important one. If you or someone you know is trying to quit smoking, Planned Parenthood’s Ask the Experts forum gives this advice for quitting:

• Try saving the money you would have spent on cigarettes to buy something special.
• Exercise to release endorphins and distract yourself from cigarette cravings.
• Socialize with nonsmokers.
• Snack on low-calorie vegetables to keep your hands and mouth active.
• Keep a list of reasons you want to quit and look at it every day.
• Enlist your family and friends to help you.
• Practice deep breathing and relaxation.
• Chew sugarless gum.
• Drink cold water.

Help is also available at Planned Parenthood health centers — Planned Parenthood Arizona has smoking-cessation programs to help you stay healthy and get the most out of your birth control. Although World No Tobacco Day serves as a good reminder and an occasion for people to quit together, any day is a good day to start quitting.