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Smoking status and symptom burden in surgical head and neck cancer patients
Author(s) -
Sterba Katherine R.,
GarrettMayer Elizabeth,
Carpenter Matthew J.,
Tooze Janet A.,
Hatcher Jeanne L.,
Sullivan Christopher,
Tetrick Lee Anne,
Warren Graham W.,
Day Terrence A.,
Alberg Anthony J.,
Weaver Kathryn E.
Publication year - 2017
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26159
Subject(s) - medicine , psychosocial , smoking cessation , swallowing , head and neck squamous cell carcinoma , pharynx , cancer , cross sectional study , lung cancer , marital status , head and neck cancer , physical therapy , surgery , psychiatry , population , pathology , environmental health
Objectives/Hypothesis 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. Study Design Cross‐sectional survey. Methods 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. Results 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). Conclusions 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. Level of Evidence 4 Laryngoscope , 127:127–133, 2017