Lung cancer is by far the deadliest cancer in the U.S. More Americans die of lung cancer than colon, breast and prostate cancers combined. Nevertheless, despite its high occurrence, questions and myths surround the disease.
What we know is smoking cigarettes is the number one risk factor. But can people who don't smoke get lung cancer? Can e-cigarettes and vaping lead to lung cancer? What about smoking cigars or a hookah?
Dr. Igor Medic, a board-certified medical oncologist affiliated with Sharp Grossmont Hospital says, "Cigarette smoking accounts for about 90% of all lung cancer diagnoses, but it's not the only risk factor."
We asked Dr. Medic to clear the air on common myths, including insights about vaping. Here's what you need to know.
Myth #1: Only smokers get lung cancer.
"Unfortunately, smoking is not the sole cause of lung cancer," says Dr. Medic. "Approximately 10% of patients with lung cancer never smoked."
Exposure to radon gas is the second most common cause. "There's also secondhand smoke, and patients who've had radiation therapy while being treated for previous malignancies are also at risk," he says.
To a lesser degree, environmental toxins like asbestos, metals such as chromium and nickel, and air pollution are associated with the disease. And although genetic lung cancer is still being investigated, there is clearly an established familial risk.
Myth #2: Vaping isn't addictive and doesn't cause lung cancer.
Vaping is done using an e-cigarette. Dr. Medic explains, "An e-cigarette is a battery-operated device that heats a liquid containing nicotine, as well as flavorings and other chemicals, to produce a vapor the user inhales."
"The devices are still largely unregulated by government, and in my opinion, represent a public health concern," he says.
E-cigarettes have risen in popularity not only among adults, but also among teens. Their small size makes them unnoticeable in school settings and fun flavors like candy, fruit or chocolate make them appealing. In 2018, one survey indicated that 21% of high school students reported the use of e-cigarettes.
"Vaping is very addictive because nicotine is an addictive substance. That said, there is no firm link yet between vaping and lung cancer. However, there have been multiple occasions when various e-liquids used in e-cigarettes were found to contain carcinogenic substances," he says.
As of this writing, the Centers for Disease Control and Prevention (CDC) has reported that more than 1,000 cases of severe lung illness may have been caused by these chemicals. Many people also refill the cartridge with various substances that increase risk of harm when heated for inhalation, like tetrahydrocannabinol (THC) or cannabidiol (CBD) oils. The exact reasons for the illnesses are still under investigation.
Besides lung illness, there is evidence that e-cigarettes can cause increased coughing, bronchitis symptoms and asthma exacerbations. There are also concerns the habit could lead to development of nicotine addiction, particularly for teens, which could be a potential gateway to use conventional cigarettes, or perhaps polysubstance use.
Myth #3: Occasional smoking won't hurt me or cause lung cancer.
There's no safe level of smoking. Any level of smoking contributes to the development of lung cancer.
Myth #4: Smoking cigars or a hookah is not harmful to your body or lungs.
Smoking cigars or a hookah is no safer than smoking cigarettes and can cause lung cancer.
A single large cigar can contain more than a half ounce of tobacco - as much tobacco as an entire pack of cigarettes. A single cigar also has 100 to 200 milligrams of nicotine versus a cigarette, which has 8 milligrams.
A hookah is a water pipe with a smoke chamber, water bowl, pipe and hose. Specially made tobacco that comes in different flavors is heated and used. The smoke passes through water and is then drawn through the hose to a mouthpiece. Some smokers claim the water filters out any toxic ingredients. But according to the CDC, the charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals and other cancer-causing chemicals, even after passing through water.
Myth #5: I've smoked all my life. Quitting now isn't going to prevent me from getting lung cancer.
Quitting smoking is one of the best health decisions you can make. According to a 2013 study in the New England Journal of Medicine, quitting before age 40 reduces your chance of dying prematurely from a smoking-related disease by 90%, and quitting by age 54 reduces your chance by 66%.
"It's very hard to quit smoking. It's one of the toughest habits to kick, but in doing so, you significantly reduce your risk of lung cancer," says Dr. Medic.
If you want to quit smoking, immediately seek help from your family doctor. Sharp offers smoking cessation classes to help guide you through the process.
For the news media: To talk with Dr. Igor Medic about lung cancer for an upcoming story, contact Erica Carlson, senior public relations specialist, at firstname.lastname@example.org.