# Specific Depressive Symptoms and Primary Tumor Location as Potential Predictors of Smoking Maintenance After Head and Neck Cancer Treatment

## TL;DR

This study finds that depressive symptoms and tumor location may predict whether HNC patients continue smoking after treatment.

## Contribution

The study identifies specific depressive symptoms and tumor location as novel predictors of smoking maintenance in HNC patients.

## Key findings

- 39.4% of patients continued smoking immediately after treatment, rising to 43.7% after 12 months.
- Sadness (measured by BDI) and oral cavity tumors predicted smoking maintenance at 12 months.
- Feeling like a failure before treatment predicted smoking maintenance both immediately and after 12 months.

## Abstract

Despite the known benefits of smoking cessation for head and neck cancer (HNC) patients, a significant proportion continue to use tobacco after treatment. Although the causes of this phenomenon are multifactorial, the underlying psychological mechanisms are still poorly understood.

Investigate the influence of sociodemographic, clinicopathological, and psychological factors on smoking cessation after treatment of HNC.

This study included 71 smoking HNC patients who had completed cancer treatment for at least 12 months. Clinicopathological characteristics and anxiety and depression symptoms extracted the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were evaluated in the pre‐treatment period. Data on smoking history was assessed through a semi‐structured interview.

A proportion of patients with HNC patients (39.4%) continued to smoke immediately after completing cancer treatment, with this proportion rising to 43.7% after 12 months of treatment. Logistic regression analyses showed that the occurrence of the primary tumor in the oral cavity (β = 6.891, P = 0.008) and the psychological symptom of sadness measured by the BDI (β = 5.279, P = 0.023) were predictive of smoking maintenance 12 months after the end of cancer treatment. Feeling like a failure before cancer treatment was the only predictor variable for smoking maintenance immediately after and 12 months after the end of treatment (β = 13.455, p < 0.001; β = 4.537, P = 0.043; respectively).

This study presents exploratory insights that identifies pre‐treatment specific depressive symptoms and primary tumor location as promising predictive factors for continued tobacco use in patients treated for head and neck cancer.