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Sep 2012, Vol 138, No. 9 >

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Original Article | Sep 2012

Changing Trends in Smoking and Alcohol Consumption in Patients With Oral Cancer Treated at Memorial Sloan-Kettering Cancer Center From 1985 to 2009

Pablo H. Montero, MD; Purvi D. Patel, MD; Frank L. Palmer, BA; Snehal G. Patel, MD; Jatin P. Shah, MD; Richard B. Hayes, DDS, PhD, MPH; Ian Ganly, MD, PhD
Arch Otolaryngol Head Neck Surg. 2012;138(9):817-822. doi:10.1001/archoto.2012.1792.
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Objective  To describe smoking and alcohol consumption trends in patients with oral cavity cancer over the past 25 years.

Design  Retrospective cohort study.

Setting  Single-institution tertiary care cancer center.

Patients  Patients with oral cancer treated primarily with surgery from 1985 to 2009. Patients with previous head and neck cancer were excluded.

Main Outcome Measures  The medical records of 1617 patients were reviewed. Patient demographics and details on smoking and alcohol consumption were recorded. Patients were divided in 5 different cohorts according to the year of initial surgery.

Results  There were no differences in sex, age, or stage of disease among cohorts. Oral tongue was the most common subsite (49%). There was a progressive decrease in tobacco use; 80% in cohort 1 vs 60% in cohort 5 (P < .001). A decrease in the daily amount of tobacco used was also found; 55% of patients in cohort 1 smoked more than 1 pack per day compared with 30% in cohort 5 (P < .001). Alcohol consumption decreased from 80% in cohort 1 to 67% in cohort 5 (P < .007). The percentage of patients who consumed more than 3 drinks per day decreased from 23% in cohort 1 to 9% in cohort 5 (P < .001).

Conclusion  Over the past 25 years there has been a progressive decrease in the prevalence of tobacco and alcohol users in patients with oral cancer.
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Figure 1. Prevalence of tobacco use.

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Figure 2. Combined smoking and drinking habit over time.

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Figure 3. Prevalence of alcohol and tobacco use by sex over time. A, Alcohol (Alc) use. B, Tobacco use.

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Figure 4. Current cigarette smoking in persons 18 years or older by sex, selected years (Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 1965-20084).

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