November marks Lung Cancer Awareness Month, a dedicated time to raise awareness about the leading cause of cancer-related deaths worldwide. Lung cancer often goes undetected until advanced stages, making early detection and prevention critical. While smoking remains the predominant cause, recent studies reveal that environmental factors, including air pollution, occupational hazards, and even passive smoking, significantly impact lung health. This month, we delve into these factors and the importance of lung health literacy, which can empower individuals and communities to take preventive actions and advocate for cleaner air and healthier environments.
Understanding Lung Cancer and Its Far-Reaching Impact
Lung cancer accounts for over 2.2 million new cases each year, representing almost 11% of all diagnosed cancers globally.[1] Its effects are devastating, often resulting in respiratory complications, painful symptoms, and an increased risk of metastasis to other organs. The survival rate for lung cancer remains lower than many other cancers due to its tendency to remain asymptomatic until it reaches advanced stages.
While smoking tobacco is undeniably the largest risk factor, accounting for 85-90% of all lung cancer cases, the narrative that lung cancer is solely a “smoker’s disease” has been challenged by an increase in non-smokers affected by the disease.[2] This shift highlights the need for public education to encompass broader risk factors and strengthen our understanding of the disease, its preventable causes, and how people of all backgrounds can protect their lung health.
Why Lung Health Literacy is Vital
The knowledge of lung cancer causes, symptoms, and prevention measures forms the foundation of what’s known as “lung health literacy.” This literacy is essential for empowering individuals to seek medical advice early, avoid exposure to known carcinogens, and actively engage in lifestyle and environmental adjustments to improve respiratory health.
The symptoms of lung cancer often mimic other benign respiratory illnesses, which leads to late-stage diagnoses. Some early symptoms include a persistent cough, shortness of breath, chest pain, and unexplained weight loss. Health literacy about these symptoms can prompt individuals to seek timely medical care. Similarly, knowing about accessible diagnostic tools, such as low-dose CT scans, can enable those at high risk to take preventive action.
Raising awareness is not just about smoking cessation but also about understanding how one’s environment, workplace, and lifestyle can impact lung health. Policies addressing these factors, including tobacco restrictions, air quality management, and workplace safety regulations, play an essential role in public lung health. By educating the public on these policies, Lung Cancer Awareness Month can drive collective action toward reducing lung cancer incidences.
Policy Changes in Tobacco Regulation and Consumption
In India, tobacco consumption has historically been high, contributing to the country’s leading share of global lung cancer cases. In response, the government has enacted strong anti-tobacco laws to deter use and protect public health. The Cigarettes and Other Tobacco Products Act (COTPA), amended in 2020, restricts the sale, promotion, and consumption of tobacco products, specifically near educational institutions. It also mandates graphic health warnings on packaging, raising awareness of the risks associated with tobacco use.
Furthermore, the Goods and Services Tax (GST) on tobacco has significantly raised the price of cigarettes and other products, dissuading consumption among younger populations and lower-income groups. The ban on e-cigarettes and flavoured tobacco products has also helped curb nicotine addiction, especially among adolescents. The World Health Organization (WHO) has praised these policies, but there is still room for stronger enforcement, particularly at the local level, where accessibility remains a challenge.
Lung Cancer Awareness Month provides an opportunity to remind individuals of these policies, encouraging adherence and advocacy for stricter local enforcement to make a lasting impact on public health. In addition, understanding these regulations fosters public support for policies that prioritize health over industry profits, as well as recognizing the broader impacts of environmental policies on respiratory well-being.
Beyond Smoking: Environmental Contributors to Lung Cancer
While smoking remains a primary cause of lung cancer, environmental factors contribute significantly to its incidence, often in ways beyond individual control. Poor air quality, driven by industrial emissions, vehicle exhaust, and crop residue burning, affects millions of lives, with urban residents exposed to alarmingly high levels of pollutants. In fact, the WHO has reported that nearly 90% of the world’s population breathes air containing high levels of pollutants, which contribute to respiratory illnesses and cancers alike.
In India, the post-harvest burning of crop stubble is a significant factor affecting air quality, especially in the northern states where it contributes to a seasonal spike in air pollution. Stubble burning releases fine particulate matter (PM2.5) into the air, which, when inhaled, can lodge in the lungs and cause inflammation and tissue damage over time, increasing the risk of lung cancer. Efforts to mitigate this include government initiatives promoting sustainable farming practices and alternative crop residue management techniques. However, a more widespread public understanding of the risks associated with stubble burning, and support for policy changes, could accelerate change.
Occupational exposure to hazardous substances such as asbestos, silica dust, and certain chemicals also plays a role in lung cancer risk. Individuals working in construction, mining, and heavy industry are particularly vulnerable. Labor laws designed to protect workers, including regulations for ventilation, protective equipment, and restricted exposure times, are essential to reducing these risks, but enforcement varies.
Lung Cancer Awareness Month is an opportune time to highlight these environmental risk factors and emphasize preventive measures, from advocating for cleaner energy sources to supporting policies limiting industrial emissions.
The Hidden Danger of Passive Smoking
The effects of second-hand smoke, or passive smoking, are often underestimated but pose serious health risks. Non-smokers exposed to second-hand smoke have an increased risk of lung cancer by about 20-30%.[3] In shared spaces, passive smoking is unavoidable, as residual smoke particles cling to surfaces and linger in the air, creating a harmful environment even after a cigarette has been extinguished. Laws regulating smoke-free environments, including workplaces, restaurants, and public spaces, are essential in protecting individuals from involuntary exposure.
However, public knowledge of passive smoking risks remains low, especially in family homes where individuals may inadvertently expose loved ones. Public education on the dangers of passive smoking can help create smoke-free zones in shared spaces and homes, while stronger policies protecting non-smokers are a crucial step toward a healthier society.
Taking a Holistic Approach to Lung Health
To effectively address the lung cancer burden, we need a multi-faceted approach that goes beyond the traditional focus on smoking cessation. This means addressing broader environmental and lifestyle factors that contribute to lung health, raising public awareness of policy protections, and advocating for stronger health-centered laws.
Lung Cancer Awareness Month provides a platform for educating the public about lung health literacy, encouraging prevention, and building a culture that values environmental policies for their health benefits. Recognizing that lung cancer does not affect only smokers, but can impact anyone exposed to hazardous conditions, we can strive for a society that safeguards its citizens through policy, education, and proactive healthcare. Every November, as we acknowledge Lung Cancer Awareness Month, we not only raise awareness but also empower communities with the knowledge to live healthier lives. By understanding the factors contributing to lung health, we can take collective actions that prioritize prevention, reduce health disparities, and create a future where lung cancer no longer carries the devastating impact it does today.
[1] GLOBOCAN 2020, International Agency for Research on Cancer (IARC) : https://gco.iarc.fr/
[2] American Cancer Society, the National Cancer Institute, and the Centers for Disease Control and Prevention (CDC). https://www.cancer.org/cancer/types/lung-cancer/causes-risks-prevention/what-causes.html / https://www.cdc.gov/lung-cancer/nonsmokers/index.html
[3] National Library of Medicine. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. https://www.ncbi.nlm.nih.gov/books/NBK44330/#:~:text=The%20pooled%20evidence%20indicates%20a,with%20living%20with%20a%20smoker.