biostudies-literatureDi Credico GNational Institute of Environmental Health SciencesLabor and Welfare of JapanNIDCR NIH HHSNIDA NIH HHSItalian Ministry of EducationNIEHS NIH HHSUCLA Jonsson Comprehensive Cancer CenterFIC NIH HHSEuropean CommunityGerman Ministry of Education and ResearchNational Institutes of HealthFondo para la Investigacion Cientifica y Tecnologica ArgentinaFundação de Amparo à Pesquisa no Estado de São PauloSpanish GovernmentMinistry of Science, Research and Arts Baden-WurttembergInternational Union Against CancerNCI NIH HHSScientific Research grant from the Ministry of Education, Science, Sports, Culture and Technology of JapanInstitut Hospital del Mar d’Investigacions MediquèsUniversità degli Studi di MilanoItalian Foundation for Cancer Research47-57https://www.ebi.ac.uk/biostudies/studies/S-EPMC7117823biostudies-literatureUnknown94<h4>Objectives</h4>This study aimed at re-evaluating the strength and shape of the dose-response relationship between the combined (or joint) effect of intensity and duration of cigarette smoking and the risk of head and neck cancer (HNC). We explored this issue considering bivariate spline models, where smoking intensity and duration were treated as interacting continuous exposures.<h4>Materials and methods</h4>We pooled individual-level data from 33 case-control studies (18,260 HNC cases and 29,844 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. In bivariate regression spline models, exposures to cigarette smoking intensity and duration (compared with never smokers) were modeled as a linear piecewise function within a logistic regressiOral oncologyJoint effects of intensity and duration of cigarette smoking on the risk of head and neck cancer: A bivariate spline model approach.PMC7117823IC18-CT97-0222R01 DE013158R03 DE016611P50 CA090388T32 CA009142R01ES011740U01 CA096134KFS-700U01CA096134P50CA090388R01 ES011740P30ES010126R01 DE013110OCS-1633R01DE013110TW001500R01CA030022R01DE013158R01DA011386R03CA113157K07 CA104231R01 DA011979P30 ES010126R03 CA113157R01CA061188R03CA077954R01DE011979R21 ES011667R01CA078609T32CA009142R01 CA100679R03 CA077954R01 CA048996IC15-CT98-0332R01CA100264R01 CA078609R01 CA100264R03DE016611R01 CA090731R01DE012609R01 DA011386R01 CA030022P01CA068384K07CA104231R21ES011667R01CA100679P01 CA068384R03 TW001500R01CA051845R01CA048996DE016631R13 CA210555R01CA90731-01R01 DE016631Agudo ALa Vecchia CPurdue MAhrens WBosetti CMatsuo KHolcatova IMorgenstern HTorelli NToporcov TNKjaerheim KBoaventura Rios LFLagiou PLazarus PWinn DMConway DILi GVilensky MSchwartz SMBrennan PMenezes ACurado MPDal Maso LDaudt AWMacfarlane TVSwiatkowska BChen CEdefonti VOlshan AFBoccia SHayes RBPolesel JZheng TSturgis EMCadoni GBrenner HBoffetta PChuang SCRudnai PGillison MHashibe MLevi FRamroth HSchantz SMates DFranceschi SKoifman RMenvielle GLee YAMcClean MYu GPDi Credico GThomson PWunsch-Filho VGross NDLuce DMoysich KZnaor ASerraino DFernandez LMuscat JGaravello WSimonato LStucker IVaughan TLSmith ENegri ED'Souza GRichiardi LZhang ZFZevallos JPHealy CLissowska JPauli FShangina OKelsey KHerrero RFabianova EfalseJoint effects of intensity and duration of cigarette smoking on the risk of head and neck cancer: A bivariate spline model approach.<h4>Objectives</h4>This study aimed at re-evaluating the strength and shape of the dose-response relationship between the combined (or joint) effect of intensity and duration of cigarette smoking and the risk of head and neck cancer (HNC). We explored this issue considering bivariate spline models, where smoking intensity and duration were treated as interacting continuous exposures.<h4>Materials and methods</h4>We pooled individual-level data from 33 case-control studies (18,260 HNC cases and 29,844 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. In bivariate regression spline models, exposures to cigarette smoking intensity and duration (compared with never smokers) were modeled as a linear piecewise function within a logistic regressi2019-01-01T00:00:00Z2019 Jul2025-04-04T07:20:08.241Z2025-04-04T07:20:08.241ZS-EPMC71178233117821210.1016/j.oraloncology.2019.05.006