PREVALENCE AND PREDICTORS OF CONTINUED TOBACCO USE AFTER TREATMENT OFPATIENTS WITH HEAD AND NECK-CANCER

Background. Patients with head and neck cancer who continue to smoke a fter diagnosis and treatment are more likely than patients who quit to experience tumor recurrence and second primary malignancies. Therefor e, information about patients' smoking status and the factors associat ed with continued tobacco use are important considerations in the comp rehensive care patients with head and neck cancer. Methods. Study part icipants were 144 patients with newly diagnosed squamous cell carcinom as of the upper aerodigestive tract who underwent surgical treatment, with or without postoperative radiotherapy or chemotherapy, 3-15 month s before assessment of their postoperative tobacco use. Results. Among the 74 patients who had smoked in the year before diagnosis, 35% repo rted continued tobacco use after surgery. Compared with patients who a bstained from smoking, patients who continued to use tobacco were less likely to have received postoperative radiotherapy, to have had less extensive disease, to have had oral cavity disease, and to have had hi gher levels of education, Hierarchical regression analysis indicated t hat most of the explained variance in smoking status could be accounte d for on the first step of analysis by disease site. Interest in smoki ng cessation was high, and most patients made multiple attempts to qui t. Conclusions. Although the diagnosis of a tobacco-related malignancy clearly represents a strong catalyst for smoking cessation, a sizable subgroup of patients continue to smoke. Patients with less severe dis ease who undergo less extensive treatment are particularly at risk for continued tobacco use. These data highlight the importance of develop ing smoking cessation interventions designed to meet the demographic, disease, treatment, and tobacco-use characteristics of this patient po pulation.