{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:40:34Z","timestamp":1790912434842,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Smoking and alcohol drinking are established causes of head and neck cancer (HNC), yet their combined effect and variation by anatomic sub\u2010site remain incompletely defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We followed 5,985,244 Korean adults (\u2265\u200930\u2009years) who attended National Health Insurance health screening in 2002\u20132003 until 31 December 2019. Smoking status (never, former, current) and alcohol intake (none, light, moderate, heavy) were self\u2010reported at baseline. Incident HNC was ascertained from the national cancer registry. Sub\u2010distribution hazard ratios (SHRs) were estimated with Fine\u2013Gray competing\u2010risk regression. Additive interaction was quantified by the relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI), and multiplicative interaction by a product term.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During 76.5 million person\u2010years of follow\u2010up (mean 13\u2010year follow\u2010up), 13,491 HNC cases were recorded. Current smoking and heavy alcohol drinking independently increased HNC risk in a dose\u2013response manner. Combined exposure to smoking and heavy drinking showed a supra\u2010additive risk for HNC overall (SHR, 2.42; 95% CI, 2.28\u20132.56; RERI, 0.63; AP, 0.26; SI, 1.79), particularly for the oral cavity, oropharynx, nasal cavity\/paranasal sinuses, and larynx. Significant multiplicative interactions were also observed in the oral cavity, oropharynx, and hypopharynx.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Concurrent cigarette smoking and heavy alcohol consumption synergistically elevate the risk of HNC across multiple subsites. Integrated public\u2010health strategies targeting both behaviors are essential to reduce the HNC burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71665","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:59:59Z","timestamp":1771635599000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Smoking, Alcohol, and Their Interaction in the Risk of Head and Neck Cancer: A Nationwide Cohort Study"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3586-5800","authenticated-orcid":false,"given":"Eunjung","family":"Park","sequence":"first","affiliation":[{"name":"Department of Cancer Control and Population Health National Cancer Center Graduate School of Cancer Science and Policy  Goyang Republic of Korea"},{"name":"Division of Cancer Prevention National Cancer Control Institute, National Cancer Center  Goyang Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee\u2010Yeon","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Cancer Control and Population Health National Cancer Center Graduate School of Cancer Science and Policy  Goyang Republic of Korea"},{"name":"Division of Cancer Prevention National Cancer Control Institute, National Cancer Center  Goyang Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuh\u2010Seog","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Center for Thyroid Cancer, National Cancer Center  Goyang Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byungmi","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cancer Control and Population Health National Cancer Center Graduate School of Cancer Science and Policy  Goyang Republic of Korea"},{"name":"Division of Cancer Prevention National Cancer Control Institute, National Cancer Center  Goyang Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7227-0593","authenticated-orcid":false,"given":"Thi Tra","family":"Bui","sequence":"additional","affiliation":[{"name":"Department of Cancer Control and Population Health National Cancer Center Graduate School of Cancer Science and Policy  Goyang Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9331-3054","authenticated-orcid":false,"given":"Jin\u2010Kyoung","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Cancer Control and Population Health National Cancer Center Graduate School of Cancer Science and Policy  Goyang Republic of Korea"},{"name":"Division of Cancer Prevention National Cancer Control Institute, National Cancer Center  Goyang Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Global Cancer Observatory: Cancer Today","author":"Ferlay J.","year":"2022"},{"key":"e_1_2_13_3_1","first-page":"1","article-title":"Personal Habits and Indoor Combustions","volume":"100","author":"International Agency for Research on Cancer","year":"2012","journal-title":"IARC Monographs on the Evaluation of Carcinogenic Risks to Humans"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.14740\/wjon1104w"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-08-0347"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.4082\/kjfm.18.0015"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-14-187"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23033"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers10010020"},{"issue":"3","key":"e_1_2_13_10_1","first-page":"799","article-title":"Data Resource Profile: The National Health Information Database of the National Health Insurance Service in South Korea","volume":"46","author":"Seong S. 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