Smoking is the Number One Cause of Lung Cancer

Smoking causes the death of approximately 5 million people annually in the world. Stating that cigarettes, which contain more than 7000 chemicals, have harmful effects on cellular functions by causing DNA damage, Anadolu Health Center Chest Diseases Specialist Assoc. Dr. Tayfun Çalışkan said, “The most common known cause of lung cancer is smoking. 80-90 percent of all lung cancers are caused by smoking and can be prevented by quitting smoking. According to 2022 cancer statistics, lung cancer is the most common disease in the United States after prostate and breast cancer. “The risk of lung cancer in smokers until the age of 80 is 14 percent,” Assoc. Prof. said in his statement. Dr. Tayfun Çalışkan gave important information about the harms of smoking…

How common is cigarette consumption?

Cigarette is a substance that contains more than 7000 chemicals (more than 60 of which are known to be carcinogenic) and has harmful effects on cellular functions by causing DNA damage. The annual global economic burden of smoking is 2 billion dollars and results in the death of half of smokers. It causes the death of approximately 5 million people annually in the world. It is estimated that 942 million men and 175 million women in the world, aged 15 and over, smoke cigarettes. Smoking varies by gender between countries. According to the International Smoking Survey, smoking in Turkey in 2016 was 31.6% of the total population, 44.1% in men and 19.2% in women.

What are the diseases caused by smoking in the lungs?

The most well-known disease associated with smoking is lung cancer. Apart from this, smoking during pregnancy and exposure to cigarettes in early childhood impairs children’s lung development and increases the risk of developing asthma. Asthma patients who smoke have a higher risk of developing chronic obstructive pulmonary disease (COPD) than non-smokers. COPD is the most common smoking-related lung disease; It is a chronic, progressive and preventable disease that progresses with cough, sputum production and shortness of breath. The most effective method to reduce the progression of COPD and related deaths is to quit smoking. It can also cause a series of diseases called interstitial lung disease (lung hardening), which disrupts the spongy structure of the lung and disrupts its normal functioning. Among these, those strongly associated with smoking are respiratory bronchiolitis, desquamative interstitial pneumonia and langerhans cell histiocytosis. Other diseases more common in smokers are idiopathic pulmonary fibrosis and rheumatoid arthritis-associated interstitial lung disease.

What is the frequency of lung cancer associated with smoking?

The most common known cause of lung cancer is smoking. About 80-90% of all lung cancers are caused by smoking and can be prevented by quitting smoking. The risk of cancer in smokers is 30 times higher than in non-smokers. According to cancer statistics for 2022, lung cancer was the most common detected in the United States (USA), after prostate and breast cancer, with 236,740 new cases. Additionally, lung cancer caused the most deaths among cancers with 130,180 cases. The risk of lung cancer in smokers by the age of 80 has been determined to be 14%.

Are all lung cancers related to smoking?

Worldwide, 15-20% of men and 50% of women with lung cancer have been found to be unrelated to smoking. When risk factors other than smoking are evaluated; advanced age, air pollution, environmental exposures (such as asbestos, chromium, arsenic), biomass exposure (burning wood and coal, cooking, smoke exposure), use of dried animal feces as fuel, radon exposure, genetic factors (family history of lung cancer), It is known that a history of chemotherapy-radiotherapy and viruses with a possible role (Epstein-bar virus, human papillomavirus, hepatitis B and C) can cause lung cancer.

Can lung cancer occur in non-smokers? What is its frequency?

In the United States, approximately 10-20% of lung cancers occur in non-smokers, and approximately 20,000-40,000 lung cancers are expected to develop in non-smokers annually.

What is the relationship between smoking duration and intensity and cancer?

Duration and intensity of smoking affect the risk of lung cancer. The risk of lung cancer in people who smoke 1-5 cigarettes a day is 9 times higher than in people who never smoke. The risk of developing lung cancer in people who smoke 1-5 cigarettes a day and quit smoking under the age of 40 was found to be similar to those who have never smoked. However, even if people who smoke 6-15 cigarettes a day quit smoking under the age of 40, their risk of developing lung cancer is 1.8 times higher than those who never smoke. The risk of lung cancer in people who smoke 1-5 cigarettes a day and quit smoking when they are over 40 years old is 3 times higher than in people who have never smoked. People who start smoking at an older age have a higher risk of lung cancer than those who start at a younger age. While the risk of lung cancer was 7.7% in those who smoked 1-5 cigarettes a day, the risk was 26.4% in those who smoked more than 35 cigarettes.

What is passive smoking? What are the risks?

Passive smoking is secondary exposure, which means being directly exposed to smoke smoked by someone else. Tertiary exposure occurs due to smoking in a closed environment and the accumulation and exposure to chemicals such as nicotine, formaldehyde and naphthalene on soft surfaces such as clothing, furniture, beds and curtains. In the United States, more than 7,300 annual lung cancers in non-smokers are due to secondary smoking exposure. Apart from this, coronary artery disease and stroke can affect pregnant women and cause low birth weight. It can also cause sudden infant death syndrome, lung infections, ear infections and asthma attacks in infants and children.

What is the relationship between hookah and cigar use and cancer?

Coal is used to heat hookah tobacco. This coal contains high levels of carbon monoxide, metals and chemicals that can cause cancer. These toxic agents reach the lungs at high levels even if inhaled through water. These can cause lung, bladder, stomach and oral cancers. It is thought by users that hookah is less harmful than cigarettes, but studies have found that nicotine, tar and other heavy metals found in cigarettes are also present in hookah smoke. An average of 1 hour of hookah use is equivalent to using 100-200 cigarettes. During this 1-hour period, 9 times more carbon monoxide and 1.7 times more nicotine are taken into the body by hookah than from a cigarette. People who smoke cigars similarly develop lung, esophagus, oral, pharynx and pancreatic cancer. There is a misconception that not breathing the cigar into the lungs is not harmful. Cigars cause less lung cancer and coronary artery disease than cigarettes and more than never smokers. Regardless of being inhaled into the lungs, similar to cigarettes, it directly interacts with the lips, mouth, tongue, throat and pharynx, and also accumulates in saliva and passes into the esophagus when saliva is swallowed. Cancers in these areas are detected similar to cigar and cigarette use.

Do electronic cigarettes cause cancer? What are the harms?

Electronic cigarettes contain potentially toxic substances. Of these, propylene glycol and vegetable glycerin are toxic substances for cells. In addition, the acetaldehyde, acrolein and formaldehyde it contains can cause lung and heart diseases. Acrolein is a herbicide used to kill harmful plants and can cause acute lung injury, COPD, asthma and lung cancer when inhaled.

Is it appropriate to use electronic cigarettes for smoking cessation purposes?

Its use for smoking cessation has also been investigated, but no effectiveness has been found in smoking cessation (US Food and Drug Administration). In animal experiments, it has been found to cause lung and bladder cancer.

What is a smoking cessation clinic? What are the tests and treatments given to patients here to quit smoking?

In the smoking cessation clinic, people who use tobacco products and want to quit are helped to quit smoking by providing psychosocial support and administering medication and nicotine replacement treatments when deemed necessary. It has been operating in Turkey since 2011. Generally, the required tests are chest radiography, respiratory function test, blood tests, electrocardiography (ECG), and carbon monoxide level measurement in breathing air and Fagerström dependency level survey can be performed; Cardiology and psychiatry consultations may be requested when necessary. Nicotine replacement therapies; Nicotine patches, nicotine gum, nicotine nasal spray, sublingual tablets, lozenges and inhalers can be used. Bupropion and varenicline are used as smoking cessation drugs. However, due to containing a suspected carcinogenic substance (nitrosamine), varenicline was recalled by the company 1.5 years ago and is not currently used.

What are the smoking cessation rates in the smoking clinic?

In the USA, 90% of patients who successfully quit smoking did so abruptly, using the self-induced cessation method. In this method, people used smoking cessation guides and non-prescribed medications. Smoking cessation success is defined as not smoking for 1 year. In the self-quitting strategy, the success rate was found to be 8-25%, while the success rate was found to be 20-40% in people applying to the smoking cessation clinic.

Are practices such as acupuncture and bioresonance recommended for smoking cessation?

Although some studies have been conducted on alternative treatment methods such as acupuncture and bioresonance for smoking cessation purposes and it has been stated that they are beneficial compared to placebo, such practices are not currently included in national and international guidelines on smoking cessation.

Finally, what is your advice to people who smoke and are thinking of quitting?

You can quit! Just take a step. We are here to help and support you.