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Epidemiologic data, including cocaine use histories, were obtained in face\u2010to\u2010face interviews. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated using hierarchical logistic regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Controlling for cumulative tobacco and alcohol use, we observed a weak positive association between cocaine use and HNC (OR<jats:sub>ever vs. never<\/jats:sub>\u2009=\u20091.35, 95% CI: 0.96, 1.90). In stratified analysis, while we did not detect associations among never tobacco or alcohol users due to the limited sample size, the association with cocaine use was observed among tobacco users and alcohol drinkers. ORs for ever and high cumulative use (&gt;18 times) versus never use were 1.40 (95% CI: 0.98, 2.00) and 1.66 (95% CI: 1.03, 2.69) among tobacco users, and 1.34 (95% CI: 0.93, 1.92) and 1.59 (95% CI: 1.00, 2.51) among alcohol drinkers, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this pooled analysis, we observed a weak positive association between cocaine inhalation and HNC risk. Our findings provide preliminary evidence of the potential carcinogenic effect of cocaine on HNC. Because of study limitations, including limited number of cocaine users, confounding, and heterogeneity across studies, future investigations will require larger studies with more detailed information on cocaine use history.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.7019","type":"journal-article","created":{"date-parts":[[2024,2,24]],"date-time":"2024-02-24T08:53:20Z","timestamp":1708764800000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cocaine use and head and neck cancer risk: A pooled analysis in the International Head and Neck Cancer Epidemiology Consortium"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7602-504X","authenticated-orcid":false,"given":"Mingyan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Epidemiology UCLA Fielding School of Public Health  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chu","family":"Chen","sequence":"additional","affiliation":[{"name":"Program in Epidemiology, Division of Public Health Sciences Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guojun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Division of Surgery University of Texas M. 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Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alzina","family":"Koric","sequence":"additional","affiliation":[{"name":"Division of Public Health, Department of Family and Preventive Medicine University of Utah School of Medicine, and Huntsman Cancer Institute  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan\u2010Chin Amy","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Public Health, Department of Family and Preventive Medicine University of Utah School of Medicine, and Huntsman Cancer Institute  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hal","family":"Morgenstern","sequence":"additional","affiliation":[{"name":"Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Department of Urology, Medical School University of Michigan  Ann Arbor Michigan 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