{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:47:57Z","timestamp":1789760877547,"version":"4.0.1"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T00:00:00Z","timestamp":1674000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Tobacco use is a major risk factor for developing head and neck squamous cell carcinoma (HNSCC). However, the prognostic associations with smoking cessation are limited. The authors assessed whether smoking cessation and increased duration of abstinence were associated with improved overall (OS) and HNSCC\u2010specific survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinicodemographic and smoking data from patients with HNSCC at Princess Margaret Cancer Center (2006\u20132019) were prospectively collected. Multivariable Cox and Fine and Gray competing\u2010risk models were used to assess the impact of smoking cessation and duration of abstinence on overall mortality and HNSCC\u2010specific\/noncancer mortality, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 2482 patients who had HNSCC, former smokers (adjusted hazard ratio [aHR], 0.71; 95% CI, 0.58\u20130.87; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.001; <jats:italic>N<\/jats:italic>\u00a0=\u00a0841) had a reduced risk of overall mortality compared with current smokers (<jats:italic>N<\/jats:italic>\u00a0=\u00a0931). Compared with current smokers, former smokers who quit &gt;10\u00a0years before diagnosis (long\u2010term abstinence; <jats:italic>n<\/jats:italic>\u00a0=\u00a0615) had the most improved OS (aHR, 0.72; 95% CI, 0.56\u20130.93; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.001). The 5\u2010year actuarial rates of HNSCC\u2010specific and noncancer deaths were 16.8% and 9.4%, respectively. Former smokers (aHR, 0.71; 95% CI, 0.54\u20130.95; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.019) had reduced HNSCC\u2010specific mortality compared with current smokers, but there was no difference in noncancer mortality. Abstinence for &gt;10\u00a0years was associated with decreased HNSCC\u2010specific death compared with current smoking (aHR, 0.64; 95% CI, 0.46\u20130.91; <jats:italic>p<\/jats:italic>\u00a0=\u00a0.012). Smoking cessation with a longer duration of quitting was significantly associated with reduced overall and HNSCC\u2010specific mortality in patients who received primary radiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Smoking cessation before the time of diagnosis reduced overall mortality and cancer\u2010specific mortality among patients with HNSCC, but no difference was observed in noncancer mortality. Long\u2010term abstinence (&gt;10 pack\u2010years) had a significant OS and HNSCC\u2010specific survival benefit.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34620","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T23:57:43Z","timestamp":1674086263000},"page":"867-877","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Cigarette smoking cessation, duration of smoking abstinence, and head and neck squamous cell carcinoma prognosis"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3364-9960","authenticated-orcid":false,"given":"John J. W.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Kunaratnam","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina J. H.","family":"Kim","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8953-1080","authenticated-orcid":false,"given":"Martha","family":"Pienkowski","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Hueniken","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Sahovaler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"},{"name":"Head and Neck Surgery University College London Hospitals  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C. L.","family":"Lam","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel C.","family":"Davies","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sinai Health System University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1546-5033","authenticated-orcid":false,"given":"John R.","family":"De Almeida","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao Hui","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John N.","family":"Waldron","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Spreafico","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology and Hematology Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayjean J.","family":"Hung","sequence":"additional","affiliation":[{"name":"Lunenfeld\u2010Tanenbaum Research Institute Sinai Health System  Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"},{"name":"Division of Medical Oncology and Hematology Princess Margaret Cancer Center University of Toronto  Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.5688"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt029"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2008.18.2188"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx486"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31416"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26083"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000342685"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537\u2010199403000\u201000009"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000509427"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010019\u201005175\u20104"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2008.18.2188"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.epi\u201009\u20100944"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.epi\u201014\u20100311"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntw189"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32849"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2010.03.015"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/tc.2008.027276"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/jop.17.00029"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2013.50.9695"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29340"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0149886"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c4690"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_8_26_1","volume-title":"RStudio: Integrated Development for R","author":"RStudio Team"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2020.2120"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.115.017719"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201507\u20101420oc"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2004.07.045"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1158\/1940\u20106207.capr\u201018\u20100441"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749\u20104486.2007.01544.x"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.02.021"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2011.03.004"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23308"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24082"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2011.38.4099"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2012.01.011"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa0912217"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26716"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13225755"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28407"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2003.04.122"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2011\u20100350"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/onco.13856"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.09.021"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.21873\/invivo.12345"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102592"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.13366"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21389"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/coc.0b013e3181dea40b"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/ftd.0b013e3181957a3b"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.34620","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.34620","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.34620","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T18:08:50Z","timestamp":1760292530000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.34620"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,18]]},"references-count":51,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,3,15]]}},"alternative-id":["10.1002\/cncr.34620"],"URL":"https:\/\/doi.org\/10.1002\/cncr.34620","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,18]]},"assertion":[{"value":"2022-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}