The nicotine dependence phenotype, time to first cigarette, and larynx cancer risk

BACKGROUND: A behavioral phenotype that characterizes nicotine dependence, the time to first cigarette after waking, is hypothesized to increase the risk of head and neck cancer. METHODS: A case-control study of histologically confirmed head and neck cancer was conducted that included 1055 cases and 795 controls with a history of cigarette smoking. RESULTS: The pack-years–adjusted odds ratio was 1.42 (95 % confidence interval [95 % CI], 1.02-1.99) for an interval of 31 minutes to 60 minutes to first cigarette after waking and 1.59 (95 % CI, 1.19-2.11) for an interval of 1 minute to 30 minutes. The risk estimates were similar when smoking was modeled as total years, smoking status (current vs for-mer), number of cigarettes smoked per day, years since quitting, and excess odds ratio. Findings were consistent for cancers of the floor of the mouth, palate, and pharynx. CONCLUSIONS: Time to first cigarette is an indicator of increased nicotine dependence, smoke uptake, and risk of head and neck cancer. This high-risk group of individuals would benefit from targeted smoking interventions. Cancer 2011;117:5377–82. VC 2011 American Cancer Society