Risky adolescent health behavior can lead to heightened risky decisions during early adulthood. This study aims to identify the impact risky adolescent health behavior, sexual experiences, and opinions on sexual encounters have on early adulthood decisions to use birth control, a way to mitigate pregnancy risks. We utilize the National Educational Longitudinal Survey (NELS:88) data and a probit model framework with marginal effects. Females who smoke tend to follow medical advice and are likely to reduce birth control use; while those who use alcohol are more likely to increase use of various birth control methods. Both males and females who engage in sexual activity for the first time later in adolescence have an increased probability to use birth control by 6 and 8 percentage points, respectively. These results support the need to expand early access to sex education, which provides necessary information for adolescents, who are already engaging in sexual activity and risky behaviors, on pregnancy prevention and sexually transmitted diseases.