Tobacco use and surgical outcomes in patients with head and neck cancer

Head Neck. 2016 May;38(5):700-6. doi: 10.1002/hed.23944. Epub 2015 May 17.


Background: Tobacco use is a risk factor for head and neck cancer, but effects on postoperative outcomes are unclear.

Methods: Patients with head and neck cancer (n = 89) were recruited before surgery. We assessed self-reported tobacco use status (never, former, or current) at study entry and recent tobacco exposure via urinary cotinine on surgery day. Outcomes included hospital length of stay (LOS) and complications.

Results: Most participants reported current (32.6%) or former (52.8%) tobacco use; 43.2% were cotinine-positive on surgery day. Complications occurred in 41.6% and mean LOS was 4.0 and 8.8 days in patients who received low and high acuity procedures, respectively. Current and former smokers were over 6 times more likely to have complications than never smokers (p = .03). For high acuity procedures, LOS was increased in current (by 4.4 days) and former smokers (by 2.3 days; p = .02).

Conclusion: Tobacco use status is associated with postoperative complications and may distinguish at-risk patients.

Keywords: cotinine; head and neck cancer; length of stay; postoperative complication; tobacco.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cotinine / urine
  • Female
  • Head and Neck Neoplasms / surgery*
  • Head and Neck Neoplasms / urine
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prospective Studies
  • Risk Factors
  • Tobacco Use / adverse effects*
  • Treatment Outcome


  • Cotinine