Strategies and successes of smoking cessation methods in head and neck cancer patients: a systematic review

Tobacco use and especially smoking tobacco is a key risk factor in the development and the progression of head and neck squamous cell carcinoma (HNSCC). Continued smoking after diagnosis worsens treatment outcomes, survival rates, and quality of life significantly. This systematic review evaluates the effectiveness of smoking cessation interventions in HNSCC patients, aiming to provide an evidence-based foundation supporting smoking cessation efforts. A comprehensive search of five databases yielded 2492 studies, of which 11 met the inclusion criteria (total patient number = 1593). These covered a range of interventions, including behavioral counseling, pharmacotherapy (nicotine replacement therapy (NRT), bupropion, and varenicline), and digital or structural support tools. Reported cessation rates ranged from 23.9 to 74% depending on the intervention type, intensity, and timing. Interventions combining counseling with pharmacological support and structured follow-up were generally more effective, particularly when initiated shortly after diagnosis. The review also highlights the potential benefits of digital tools, integrated care approaches, and opt-out systems. Despite the substantial heterogeneity across studies, which prohibited a formal meta-analysis, the findings underscore the importance of a tailored, multimodal approach to smoking cessation in HNSCC patients. Implementation barriers such as limited resources and organizational constraints persist, and further research is needed to determine the optimal follow-up strategies and address comorbidity-inducing behavioral factors.