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Head Neck. 1999 Aug;21(5):420-7.

Smoking withdrawal and relapse in head and neck cancer patients.

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Department of Behavioral Science, Box 243, UT M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4095, USA.



Smoking withdrawal and relapse were characterized among newly diagnosed head and neck cancer patients participating in a physician-delivered smoking cessation intervention.


Patients completed questionnaires at baseline, 1, 6, and 12 months following intervention delivery.


Significant baseline predictors of smoking relapse included medical treatment (XRT versus surgical treatment), stage of change/readiness to quit (precontemplators), age of initiation (younger), and greater addiction (smoking </=30 minutes after waking). Relapsers were significantly more likely to quit using gradual reduction versus cold turkey and had less confidence in remaining quit. Relapsers experienced significantly higher levels of anxiety and craving during withdrawal. Relapse was temporally delayed compared with healthy populations.


Assistance with cessation efforts should be ongoing for one year and should include nicotine replacement therapy and psychotropic medications to address significant relapse triggers.

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