title: Smoking status and symptom burden in surgical head and neck cancer patients.
abstract: Head and neck squamous cell carcinoma (HNSCC) patients who smoke are at risk for poor treatment outcomes. This study evaluated symptom burden and clinical, sociodemographic, and psychosocial factors associated with smoking in surgical patients to identify potential targets for supportive care services.
  
  
  
  Cross-sectional survey.
  
  
  
  Individuals with HNSCC of the oral cavity, larynx, or pharynx were recruited from two cancer centers and completed questionnaires assessing smoking status (never, former, current/recent), patient characteristics, and symptoms before surgery.
  
  
  
  Of the 103 patients enrolled, 73% were male, 52% were stage IV, 41% reported current/recent smoking, and 37% reported former smoking. Current/recent smokers were less likely than former smokers to have adequate finances (53% vs. 89%, P = .001) and be married/partnered (55% vs. 79%, P = .03). Current/recent smokers were also more likely than both former and never smokers to be unemployed (49% vs. 40% and 13%, respectively, all P = .02) and lack health insurance (17% vs. 5% and 13%, respectively, all P ≤.04). Fatalistic beliefs (P = .03) and lower religiosity (P =.04) were more common in current/recent than never smokers. In models adjusted for sociodemographic/clinical factors, current/recent smokers reported more problems than former and never smokers with swallowing, speech, and cough (P ≤.04). Current/recent smokers also reported more problems than never smokers with social contact, feeling ill, and weight loss (P ≤ .02).
  
  
  
  HNSCC patients reporting current/recent smoking before surgery have high-risk clinical and sociodemographic features that may predispose them to poor postoperative outcomes. Unique symptoms in HNSCC smokers may be useful targets for patient-centered clinical monitoring and intervention.
  
  
  
  4 Laryngoscope, 127:127-133, 2017.
authors.affiliation: Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Sterba
authors.affiliation: Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Garrett-Mayer
authors.affiliation: Department of Psychiatry and Behavioral Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Carpenter
authors.affiliation: Department of Biostatistical Sciences and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Janet A
authors.initials: JA
authors.lastname: Tooze
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Jeanne L
authors.initials: JL
authors.lastname: Hatcher
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Christopher
authors.initials: C
authors.lastname: Sullivan
authors.affiliation: Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Lee Anne
authors.initials: LA
authors.lastname: Tetrick
authors.affiliation: Department of Radiation Oncology and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Graham W
authors.initials: GW
authors.lastname: Warren
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Terrence A
authors.initials: TA
authors.lastname: Day
authors.affiliation: Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Alberg
authors.affiliation: Department of Social Sciences and Health Policy and Comprehensive Cancer Center of Wake Forest University, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A.
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Weaver
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*; D000077195:Squamous Cell Carcinoma of Head and Neck; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Head and neck cancer; cigarette smoking; oral cancer; surgery; symptoms; tobacco