Xiao R, Pham Y, Ward MC, et al. - In this retrospective cohort study involving 484 individuals (94 were active smokers, 226 were former smokers, and 164 never smoked), researchers analyzed the role of smoking in patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC). The sample consisted of patients with HPV(+) OPSCC from 2001 to 2015 at a tertiary-care institution. According to findings, 82 patients had a ≥ 10 pack-year and 69 had a ≥ 20 pack-year smoking history among active smokers. Active smoking was a significant predictor of inferior OS and PFS after adjusting for covariates. The authors discovered that ≥ 20 pack-years anticipated a reduced effect-size for inferior OS and PFS when including pack-years as the covariate. Overall, the authors concluded that active smoking at diagnosis is the most robust covariate capturing smoking history to anticipate OS and PFS for individuals with HPV(+) OPSCC.