This study compared the sociodemographic and cardiovascular correlates of oral contraceptive users and nonusers between 1981 and 1993. We also sought to determine changes in the prevalence of oral contraceptive use among older premenopausal women. Using data from six biennial cross-sectional household surveys in a population-based sample of two New England communities, 5239 women between ages 18 and 45 years were identified. Women using oral contraceptives were 5 years younger and better educated than nonusers, and users more frequently reported a per capita income above the median for the survey population than nonusers. Users were more likely to report smoking and have a lower body mass index than nonusers. Little use of oral contraceptives was detected among women ages 40-45 years despite changes in FDA recommendations about their use and increasing evidence of their noncontraceptive benefits in healthy older nonsmoking women.