Additional resources are needed to promote tobacco cessation to patients with head and neck cancer (HNC), according to results of a study published in The Oncologist.

Despite evidence of improved treatment outcomes in HNC from avoiding tobacco use, many patients experience challenges with cessation. To better understand barriers and facilitators responsible for a patient’s continued tobacco use, researchers from University of Alabama at Birmingham School of Medicine conducted this study.

Twenty-one patients with HNC who had a history of tobacco use and 10 clinicians participated in in-depth qualitative interviews about tobacco use and cessation.

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The patients were former (57.1%) or current (42.9%) tobacco users, 66.7% were male, mean age was 59.0 years (range, 36 to 73), and 71.4% were White.

The major motivations for continuing to smoke were stress relief and enjoyment. However, the patients acknowledged smoking increased their risk for many illnesses and had a negative impact on their personal hygiene. Many patients reported quitting after their cancer was diagnosed but 40% had never attempted to quit.

Most patients reported their healthcare provider inquired about their tobacco use during visits, and the majority were encouraged to quit. Most patients were unaware of cessation resources but indicated such programs should involve former smokers, written materials, and the support of their loved ones.

The clinicians included head and neck/oral and maxillofacial surgeons, an inpatient and an outpatient nurse, a medical oncologist, a radiation oncologist, and a physician assistant.

From their perspective, the clinicians felt patient socioeconomic status was a significant barrier to tobacco cessation, and they expressed the need for additional support. Many thought resources for patients were limited, one reported having no formal training on how to approach smoking cessation, and some mentioned a lack of time to adequately address the topic with their patients.

The study authors note these data may not be generalizable to other cancer populations or regions.

Patients with HNC who used tobacco faced significant challenges, requiring additional support to achieve cessation, they concluded.


Khodadadi AB, Carroll W, Lee EL, Hansen B, Scarinci IC. It takes two to tango: patients’ and providers’ perspectives in tobacco cessation and head/neck cancer. Oncologist. 2021;26(9):761-770. doi:10.1002/onco.13856