Aims: Tobacco smoking and alcohol consumption are well-established risk factors in head and neck cancers, but their impact can vary by tumour site and population. This study evaluates the prevalence of smoking and alcohol use among patients with head and neck malignancies and analyses their association with clinical characteristics in a regional cohort.Methods: We conducted a retrospective analysis of 130 patients (age 18–80) with head and neck cancer treated at two tertiary centres in Diyarbakır, Turkey, from July to October 2025. Data on tobacco and alcohol use were collected via standardized patient interviews and chart review. Chi-square tests assessed associations between categorical variables (e.g. smoking status vs. tumour site), and Mann-Whitney U tests compared continuous variables (e.g. age) between groups.Results: The majority of patients (85.4%) had a history of tobacco use, and 40% reported regular alcohol consumption. Median smoking exposure among ever-smokers was 30 pack-years (IQR 20–45). Laryngeal cancer patients were almost universally smokers, whereas a subset of oropharyngeal and nasopharyngeal cancer patients had no history of tobacco or alcohol use. No significant difference in median age at diagnosis was observed between ever-smokers and never-smokers (p>0.05). Patients with combined heavy smoking and drinking habits tended to present with slightly younger ages and advanced-stage disease, though these trends did not reach statistical significance.Conclusions: Tobacco use was highly prevalent among head and neck cancer patients in our cohort (especially in laryngeal cancers), underscoring its central etiologic role. Alcohol consumption was less common overall, but still notable in a substantial.