Smoking and Alcohol have been implicated in the development and maintenance of squamous cell carcinoma with an almost synergistic effect. We review the effect and timing of smoking, drinking and smoking cessation upon the peri-operative morbidity and mortality for oral cancer surgery.

A controlled cohort involved 67 patients who were diagnosed with oral squamous cell carcinoma. The smoking and drinking habits of this groups was recorded, in addition cessation of smoking after diagnosis was assessed; these were compared to TNM, depth of invasion, pattern of invasion, dysplasia at margin, vascular and nerve invasion, recurrence, 3 and 5 years survival and cause of death.

Smokers are nearly twice as likely to suffer worsened prognosis as non smokers with ex-smokers in an intermediate deleterious position (p < 0.01). Alcohol is associated with a detrimental effect but the effect was not significant, this may be due to the small sample size.

Smoking does have an adverse effect on peri-operative outcome and eventual prognosis. We would commend patients to stop smoking to improve outcomes especially during treatment (i.e. surgery or radiotherapy).