## 4 Discussion
\begin{table}
\begin{tabular}{c c c c} \hline \hline
**Number of Affected Relatives** & \begin{tabular}{c} **Test Group** \\ **n (\%)** \\ \end{tabular} & \
\begin{tabular}{c} **Control Group** \\ **n (\%)** \\ \end{tabular} &
\begin{tabular}{c} **Total** \\ **n (\%)** \\ \end{tabular} \\ \hline
**General Family History of Cancer** & & & \\ None & 90 (37.6) & 93 (38.9) & 183 (38.3) \\
1 & 74 (31) & 80 (33.5) & 154 (32.2) \\
2 & 41 (17.2) & 39 (16.3) & 80 (16.7) \\ \(\geq\)3 & 34 (14.2) & 27 (11.3) & 61 (12.8) \\
**Family History of Head and Neck Cancer** & & & \\ None & 220 (92.1) & 228 (95.4) & 448 (93.7) \\
1 & 18 (7.5) & 11 (4.6) & 29 (6.1) \\
2 & 0 (0) & 0 (0) & 0 (0) \\ \(\geq\)3 & 1 (0.4) & 0 (0) & 1 (0.2) \\ \hline \hline \end{tabular}
\end{table} 
Table 6: Distribution of patients according to the number of affected relatives. The benefit of smoking cessation may be a time-dependent benefit. It was found that the risk of oral cancer among non-smokers was similar to former smokers after 10 years of smoking cessation. In addition, smoking cessation after or in middle age might dramatically decrease the risk of oral cancer [24; 33]. In our study, former smokers who stopped smoking for more than 10 years, were considered non-smokers. The link between alcohol and HNC seems to be dose-related. The association of alcohol with the risk of oral cancer may differ according to the drinking pattern; including the type, number and frequency of drinks [30; 34]. The highest incidence and mortality of oral cancer was shown in Eastern European populations where the consumption of spirits was higher than in other populations [35]. [PERSON] et al. analyzed risk factors for oral and oropharyngeal cancers on male patients. They found that the OR increased in patients consuming more than 21 whiskey equivalents per day, which were considerable amounts [36]. In contrast, approximately 88.5% of the drinker patients in our study were consuming only wine. In addition, the majority of patients were consuming low to medium wine quantities, ranging from 0.5 to 2 glasses of wine per day at mealtime. The dietary habit was reported as an issue to be considered in the alcohol risk analysis. Wine is usually consumed at mealtime in the Mediterranean area. There was reported evidence that demonstrated health-promoting effects related to low and moderate red wine at mealtimes [34; 37]. In a systemic review, protection against certain cardiovascular diseases and reduction of morbidity and mortality were associated with this nutritional habit [38]. There are two xenobiotics in wine; ethanol and phytochemicals. Phytochemical chemicals are beneficial bioactive compounds [34]. Since a reduced risk of cancer was associated with the high fruit and vegetable consumption, this dietary habit may promote health benefits through the synergetic effect between phytochemicals contained in wine and nutraceuticals of consumed fruits and vegetables [39; 40]. Studies demonstrated the reduction of incidence rates for lip and oral cancer in Mediterranean countries (e.g. Italy) where consuming red wine is common with a healthy diet [34; 35]. In order to overcome a repeated drawback in the way of reporting the total volume of ethanol intake, it was proposed a standard drinks unit for each country from which the gram (g) of ethanol can be calculated for each drink. The standard unit for a drink in Italy was equal to 12g of ethanol [34]. According to this proposed standard drink unit, 70.9% of the participants of this study were consuming \(\leq\)24g of ethanol per day. The literature suggested that the self-report tools for the collection of data of alcohol intake was valid. It was verified that self-report tools gave similar data when compared to other objective measures of alcohol intake; such as transdermal alcohol sensors. However, there are still concerns about the design of the questions for obtaining the data to avoid social desirable responses [16]. No statistical significance was observed in this study in regard to the FHC as a risk of OSCC.