title: Nicotine dependence phenotype, time to first cigarette, and risk of head and neck cancer.
abstract: BACKGROUND
  A behavioral phenotype that characterizes nicotine dependence, the time to first cigarette after waking, is hypothesized to increase the risk of head and neck cancer.
  
  
  METHODS
  A case-control study of histologically confirmed head and neck cancer was conducted that included 1055 cases and 795 controls with a history of cigarette smoking.
  
  
  RESULTS
  The pack-years-adjusted odds ratio was 1.42 (95% confidence interval [95% CI], 1.02-1.99) for an interval of 31 minutes to 60 minutes to first cigarette after waking and 1.59 (95% CI, 1.19-2.11) for an interval of 1 minute to 30 minutes. The risk estimates were similar when smoking was modeled as total years, smoking status (current vs former), number of cigarettes smoked per day, years since quitting, and excess odds ratio. Findings were consistent for cancers of the floor of the mouth, palate, and pharynx.
  
  
  CONCLUSIONS
  Time to first cigarette is an indicator of increased nicotine dependence, smoke uptake, and risk of head and neck cancer. This high-risk group of individuals would benefit from targeted smoking interventions.
authors.affiliation: Department of Public Health Sciences, Penn State College of Medicine, 500 University Blvd, Hershey, PA 17033, USA. jmuscat@psu.edu
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Muscat
authors.forename: Kwangmi
authors.initials: K
authors.lastname: Ahn
authors.forename: John P
authors.initials: JP
authors.lastname: Richie
authors.forename: Steven D
authors.initials: SD
authors.lastname: Stellman
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012306:Risk; D012907:Smoking / Q000009:adverse effects; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000150:complications*