Around the time you catch your breath after finishing head and neck cancer treatment, there is something you are sure to hear from your doctor: "Now you really have to quit tobacco and alcohol." At first it may sound like just a routine nagging, but once you actually learn the reason, your thinking shifts a little. Head and neck cancer — the kind that forms in places like the inside of the mouth, the tongue, the throat, and the larynx — grows in the very passage that smoking and drinking directly touch. Even though treatment removed the cancer mass, if cigarette smoke and alcohol keep passing through that passage, a new cancer can start from mucosa that looked perfectly fine.
What is especially frightening is when the two go together. Compared with smoking alone or drinking alone, doing both at once does not just add up the risk — it leaps up by multiplication. Alcohol slightly wears down the mucosa, letting the carcinogens in tobacco seep in more deeply. One person said, "I went through all that suffering with treatment; if it recurs, I really don't think I could endure it then." In fact, that very fear is also the most honest starting point for quitting tobacco and alcohol.
But if quitting happened by resolve alone, who would suffer? With tobacco, getting help has a far higher success rate than holding out on willpower. Public-health-center smoking-cessation clinics and hospital cessation counseling run almost free of charge, and you can be prescribed nicotine patches, gum, and even oral medication together. Because withdrawal symptoms drop sharply, the burden of "toughing it out grimly" eases. If quitting all at once is hard, keeping a smoking diary for a few days works surprisingly well too. Once you know when you most want to smoke, you can turn your hands and mouth elsewhere at that time, such as by taking a walk or drinking water.
Alcohol has its own knacks as well. After head and neck cancer treatment, the mouth is often dry and swallowing uncomfortable, and alcohol makes this worse. If it stresses you to hear "why aren't you drinking?" every time at a gathering, it is more comfortable to just say honestly, once, "I quit because I'm in treatment." Holding a non-alcoholic drink or sparkling water in your hand also lets you naturally pass on offered drinks. Keeping no alcohol in the house at all, and doing something else for just five minutes when you want to drink — when these small devices pile up, they carry you further than you would think.
Quitting tobacco and alcohol does not only prevent recurrence. Once you quit, your appetite returns, your sleep deepens, and the mucosa made sensitive by radiation recovers faster. The relief of hearing the doctor say "it's clean" each time they look into your throat at a regular checkup — that, in the end, is the reward for the time you spent quitting. Do not give up with "I knew I couldn't do it" just because you smoked again for a few days or had a drink or two. You just press the start button again. Quitting is completed not by a single resolve but by many fresh starts.
What is written here is a general account, so it is right to be sure to decide on your own treatment course and medication situation in consultation with your attending physician.
This article is intended to convey general medical information in an accessible way and does not replace individual diagnosis or treatment. Please be sure to consult your own physician for any specific decisions.