ASSOCIATION BETWEEN SMOKING DURING RADIOTHERAPY AND PROGNOSIS IN HEAD AND NECK CANCER: A FOLLOW-UP STUDY George P. Browman, MD, 1,2 E. Ann Mohide, BscN, MHSc, MSc, 3 Andrew Willan, PhD, 1,9 Ian Hodson, MD, 1,2 Gene Wong, MD, 4 Laval Grimard, MD, 5 Robert G. MacKenzie, MD, 6 Samy El-Sayed, MD, 7 Edward Dunn, PhD, FCACB, 1,8 Sylvia Farrell, BA 1,2,10 1 McMaster University, Hamilton, Ontario Canada 2 The Hamilton Regional Cancer Center, 699 Concession St., Hamilton, Ontario L8V 5C2 Canada. E-mail: george.browman@hrcc.on.ca 3 School of Nursing, McMaster University, Hamilton, Ontario, Canada 4 University of New Mexico, Albuquerque, New Mexico 5 University of Ottawa and Ottawa Regional Cancer Center, Ottawa, Canada 6 University of Toronto and the Toronto-Sunnybrook Regional Cancer Center, Toronto, Canada 7 The University of Manitoba and Cancer Care Manitoba, Manitoba, Canada. Current address, Ottawa Regional Cancer Center and University of Ottawa, Ottawa, Canada 8 St. Joseph’s Hospital, Hamilton Ontario, Canada. Current address, Clinical and Psychopharmacology Research Laboratories, CAMH 9 Father Sean O’Sullivan Research Center, St. Joseph’s Hospital, Hamilton, Ontario, Canada 10 Supportive Cancer Care Research Unit, Hamilton Regional Cancer Center, Hamilton, Ontario, Canada Accepted 28 May 2002 Published online 10 September 2002 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/hed.10168 Abstract: Background. The study objective was to confirm a previous finding that patients with stage III/IV squamous head and neck cancer (SHNC) who smoke during radiotherapy (RT) experience reduced survival. Methods. An observational cohort study. Patients’ smoking status was assessed weekly by questionnaire plus blood coti- nine. Patients were assessed every 3 to 4 months for survival. Logistic regression and Cox proportional hazards analyses were used to detect the independent contribution of smoking on sur- vival. Results. Of 148 patients, 113 smoked during RT. Blood co- tinine and smoking questionnaire responses were highly corre- lated (Spearman R = .69; p < .0005). Abstainers and very light smokers experienced better survival than light, moderate, and heavy smokers (median, 42 vs 29 months; p = .07). Tumor and nodal status and years smoked were the most important prog- nostic factors. Smoking during RT was not an independent pre- dictor of survival, but baseline smoking status was (p = .016). Correspondence to: G. Browman Contract grant sponsor: an operating grant from the National Cancer Institute of Canada. Support was also provided by the Supportive Cancer Care Research Unit, Dr. Timothy Whelan, Director, and by the Ontario Clinical Oncology Group, Drs. Mark Levine and Kathleen I. Pritchard, Directors. Presented at the Workshop on the Biological Prevention and Treatment of Head and Neck Cancer, Arlington, Virginia, September, 1994. © 2002 Wiley Periodicals, Inc. Smoking in Radiation Therapy and Head and Neck Cancer HEAD & NECK December 2002 1031