Title: Patterns of Nicotine Dependence and Nicotine Withdrawal in newly diagnosed patients of Head and Neck Squamous Cell Carcinoma: experience from a tertiary care centre in eastern India

Authors: Dr Barnini Ghosh, Dr Anish Dasgupta

 DOI: https://dx.doi.org/10.18535/jmscr/v6i12.85

Abstract

Context: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. In India, cancer of the lip and oral cavity is the most common cancer among males. Risk factors for developing HNSCC include genetic background, geographical location, diet, tobacco and alcohol abuse. Cigarette smoking and excessive alcohol consumption, besides being independent risk factors, also have synergistic effect.

Aims: To evaluate the prevalence of nicotine addiction and patterns of nicotine withdrawal in newly diagnosed patients of HNSCC.

Settings and Design: Single institutional, Prospective study in a tertiary care hospital

Methods and Material: Newly diagnosed patients of HNSCC attending the Radiotherapy OPD were evaluated for patterns of nicotine addiction and severity of dependence using the Fagerstrom Test for Nicotine Dependence (FTND). Later, they were evaluated for signs/symptoms of nicotine withdrawal using Minnesota Nicotine Withdrawal Scale – Revised (MNWS-R) when they were admitted for neoadjuvant or concurrent chemotherapy.

Statistical analysis used: IBM SPSS Version 23

Results: Out of the 73 cases (67 males, 6 females) studied, 87.7% had consumed tobacco. 4.1% were active users with high levels of dependence (as per FTND). Significant correlation between duration of tobacco cessation and duration of symptoms was observed. Symptom evaluation with MNWS-R showed 4 out of 10 major determinants of well-being- pain, insomnia, anxiety and headache and correlated with the overall daily symptom score. None of the patients suffered from nicotine withdrawal.

Conclusions: Diagnosis of malignancy is a strong motivation for tobacco cessation. Larger sample size and multicentric studies are required for further validation.

Keywords: nicotine dependence, nicotine withdrawal, Fagerstrom Test, Minnesota Nicotine Withdrawal Score-Revised.

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Corresponding Author

Dr Anish Dasgupta

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Phone No. – 9830843385