FACTORS AFFECTING SMOKING CESSATION IN PATIENTS WITH HEAD AND NECK-CANCER

The role of tobacco in the etiology of upper aerodigestive tract carci nomas is well established. Smoking decreases the effectiveness of canc er therapy and increases the risk of all treatment modalities. Smoking adversely affects the general health of the cancer survivor and place s the patient at risk of developing additional primary tumors. The smo king habits of head and neck cancer patients were evaluated using a qu estionnaire administered at two tertiary head and neck cancer centers. Demographic factors, level of exposure, tumor stage and location, tre atment modalities, concomitant alcohol use, and cessation methods were examined. Results demonstrate a high rate of smoking cessation at the time of cancer diagnosis. Significant demographic factors were not id entified. Physical barriers to continued smoking because of cancer tre atment as well as counseling at the time of tumor diagnosis were the m ost effective deterrents to continued tobacco use. Heavy alcohol use w as a negative predictor of smoking cessation. Pharmacologic aids alone were found to be of no value. This study demonstrates the difficultie s with smoking cessation in head and neck cancer patients, and emphasi zes the importance of intervention by the otolaryngologist-head and ne ck surgeon.