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7%; 95% CI 96.3%-100.0%) had significantly better 5-year OS than their ≥10 pack-years (84.8%; 95% CI 76.4%-94.1%) counterparts. In a multivariable analysis, ≥10 pack-years smoking was associated with increased hazard of death when adjusting for AJCC-8 clinical (HR 2.52; 95% CI 1.16-5.46) and pathologic (HR 5.21; 95% CI 1.47-18.5) stage. In both analyses, stage III patients demonstrated worse survival than stage I, and smoking had greater impact at lower stages. CONCLUSIONS Smoking is a negative prognosticator in HPV-positive OPSCC