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Aim: The aim of the study is to examine if continuation of smoking after treatment is an independent factor affecting the prognosis of laryngeal cancer. Materials and Methods: A total of 153 patients met the inclusion criteria for this prospective study, and they were followed up for 12–60 months. Smoking cessation/continuation rates were recorded and associated with disease recurrence and overall patient survival. Results: The recurrence rate was 35.29%. Twenty-five percent of the patients continued smoking after treatment, 75% stopped. Of the patients who quit smoking, 28.69% died during the follow-up period, compared to 52.63% of those who continued (p = 0.0047). The respective recurrence rates were 28.7 and 55.26% (p = 0.0022). A stepwise multivariate Cox regression analysis eliminated potential confounders regarding the overall survival rate and confirmed that time between symptom onset and diagnosis, T and N stage and continuation of smoking after treatment are statistically significant factors. Among them, continuation of smoking was found to have the strongest correlation to the overall survival rate. Conclusion: Continuation of smoking after treatment of laryngeal cancer is an independent negative prognostic factor. From a clinical standpoint, all patients with known laryngeal cancer should be strongly encouraged to quit smoking.

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