Lung Cancer Doesn’t Just Happen to Those Who Smoke

Every year, nearly 230,000 Americans are diagnosed with lung cancer. While most people who develop the disease have a history of tobacco use, never-smokers (people who have never smoked) account for up to 20 percent of cases, according to the Centers for Disease Control and Prevention.

National Lung Cancer Awareness Month serves as a reminder to understand your lung cancer risks and whether screening is right for you. Here’s what to know if you currently use tobacco, used to smoke tobacco, smoke marijuana, or vape.

The changing face of lung cancer

For decades, lung cancer was associated with older men with a long history of smoking. Today, lung cancer is increasingly found in women, those who have never smoked, and people at younger ages.

These trends are concerning because people in these groups often miss the early warning signs. Many are treated for conditions such as adult-onset asthma, allergies, or pneumonia before discovering they actually have lung cancer. By that point, the disease is often advanced and harder to treat. Many lung cancers found in never-smokers also involve a genetic mutation or alteration in the cancer that affects treatment options. 

Who should get screened?

A low-dose chest CT scan is the most effective way to detect lung cancer early, when it’s easiest to treat. However, only the highest risk people are recommended to undergo screening. The American Cancer Society recommends annual screening for adults ages 50 to 80 who have at least a 20 pack-year cigarette smoking history (a pack-year is the equivalent of one pack of cigarettes per day for a year).

Other factors that increase lung cancer risk include:

• Have a family history of lung cancer in first-degree relative
• Have a personal history of chronic lung disease (COPD, pulmonary fibrosis)
• Have been exposed to radon or asbestos
• Personal history of cancer or have received chest radiation previously
• Occupational exposures (coal smoke, diesel fumes, silica, and others) 

If you don’t meet criteria for lung cancer screening but have other risk factors, please discuss with your primary care provider as lung imaging may be indicated. 

What about marijuana and vaping? 

Cigarette smoking is the most significant risk factor for lung cancer, but while research is still emerging, marijuana and vaping can also harm your lungs.  

Marijuana use has climbed more than 20 percent in states where it’s legal, including Maryland. Marijuana smoke contains many of the same chemicals found in cigarettes, such as ammonia, benzene, carbon monoxide, cyanide, and tar—all linked to higher cancer risk. It also irritates the lungs and can cause chronic bronchitis, which leads to more mucus, persistent coughing, and shortness of breath.

Vaping liquids contain fewer chemicals than cigarettes, but some ingredients, such as formaldehyde, heavy metals, and benzene, raise health concerns. Recent research connects vaping to biomarkers like DNA damage and cell death, which are associated with a higher cancer risk.

Vaping also raises the risk of other lung diseases, including e-cigarette or vaping use-associated lung injury (EVALI), which causes lung scarring and inflammation. Chemicals that sweeten vaping liquids are also linked to bronchiolitis obliterans, or “popcorn lung,” a condition that narrows airways and makes breathing difficult.

Protect your health 

Cigarette smoking is the leading risk factor for lung cancer, and according to the latest state data, 9 percent of adults in Maryland smoke cigarettes. While this rate has significantly decreased over the past decade, many Marylanders continue to smoke. If you use tobacco, please call 443-481-5366 to speak with a Luminis Health tobacco treatment specialist about free resources and medication available to help you quit.

Whether you smoke or not, if you experience concerning symptoms such as recurring respiratory infections, trouble breathing, hoarseness or wheezing, or an enduring cough, talk to your primary care provider about options for you. You may not qualify for lung screening, but a more in-depth evaluation including a diagnostic CT scan can lead to earlier detection, more effective treatment, and better outcomes.

Visit Luminis.Health/PrimaryCare to make an appointment today.