Lung cancer is perhaps one of the most common and deadly forms of cancer that is being experienced worldwide, including India. For many years, lung cancer has be linked with smoking and the major interventions that provide health education for the disease aim at stopping smoking. However, recent studies have revealed a surprising and concerning trend: The situation is further complicated by the fact that a rising number of lung cancer patients are not linked to smoking. This trend has raised many concerns as it alters the demography of lung cancer patients changing the concept of risk factors associated with lung cancer among non-smokers.

Lung cancer is also prevalent in India and new cases are reported frequently every year in the country.. As per WHO, Lung cancer falls in the first three cancers in India and its occurrence is on the rise. Majority of these instances have been blamed on smoking, and research shows that more than seventy percent of the man cases of lung cancer are as a result of the use of tobacco products. But lately the problem that has emerged is the increase in lung cancer among people who have never smoked. However, according to multiple research, non-smokers are now accounting for a large proportion of lung cancer patients in India particularly women.

The rising number of non-smoking lung cancer patients in India has puzzled medical researchers and healthcare professionals. While smoking remains the leading cause of lung cancer, non-smokers are now facing a significantly higher risk due to a range of environmental and genetic factors. One of the primary factors contributing to this rise is exposure to air pollution , which is a major public health issue in India. The country is home to some of the world’s most polluted cities, where levels of particulate matter, industrial emissions, and vehicular pollution are alarmingly high.

Long-term exposure to such pollutants can damage the lungs, increase oxidative stress, and lead to the development of cancerous cells. Numerous studies have highlighted the strong link between air pollution and lung cancer, particularly in non-smokers, and suggest that the growing pollution levels in urban areas are contributing to the rise in cases.



Indoor air pollution is another significant risk factor, particularly in rural areas of India where the use of biomass fuels like wood, coal, and cow dung for cooking is widespread. These fuels release harmful pollutants, including particulate matter and carbon monoxide, into the air, which can be inhaled over long periods and cause lung damage. Women, who are primarily responsible for cooking in many households, are disproportionately affected by indoor air pollution and are therefore at higher risk of developing lung cancer. Despite the growing awareness of air pollution, efforts to mitigate its effects have been slow, and it remains a major contributor to the rising lung cancer cases in non-smokers.

Genetic factors also play a role in the development of lung cancer in non-smokers. Research has shown that individuals with certain genetic mutations may be more susceptible to the carcinogenic effects of environmental pollutants and other factors. These genetic predispositions can increase the likelihood of lung cancer in individuals who have never smoked, although such cases are still relatively rare. However, with increasing environmental exposure, the number of non-smokers with genetic vulnerability to lung cancer may be rising as well.

Another contributing factor to the rise in non-smoking lung cancer is the changing lifestyle patterns in India. As the country becomes more urbanized, more people are moving into cities with poor air quality and are adopting sedentary lifestyles that may lead to other health problems. Furthermore, an increase in the consumption of processed foods, alcohol, and unhealthy diets may also be contributing to a higher incidence of lung cancer in non-smokers. Though these factors are not as directly linked to lung cancer as smoking or pollution, they may weaken the body’s immune system and make it more vulnerable to cancer.

The rise of non-smoking lung cancer cases has significant public health implications. It challenges the conventional wisdom that smoking is the primary cause of lung cancer and calls for a broader focus on the environmental and lifestyle factors that may also contribute to the disease. For instance, air pollution, which affects millions of people daily in India, should be addressed as a major risk factor for lung cancer in both smokers and non-smokers alike. Improving air quality through stricter regulations on industrial emissions, reducing vehicular pollution, and transitioning to cleaner energy sources could significantly reduce the risk of lung cancer.

In addition to addressing environmental pollution, greater awareness needs to be raised about the risks of indoor air pollution, especially in rural areas. Providing clean cooking alternatives, such as electric stoves or liquefied petroleum gas (LPG), could significantly reduce the exposure of women and children to harmful smoke from biomass fuels. Public health campaigns that focus on these issues, as well as the need for early screening and diagnosis, could help reduce the burden of lung cancer in India.

In conclusion, the rise of lung cancer among non-smokers in India is a concerning trend that demands urgent attention. The increasing prevalence of air pollution, indoor pollution, and genetic vulnerability is contributing to the growing number of lung cancer cases among people who have never smoked. Addressing these environmental risk factors, alongside efforts to reduce smoking rates, will be crucial in combating this silent epidemic. Public health initiatives focusing on pollution control, cleaner cooking technologies, and genetic research, along with improved screening programs, can help mitigate the impact of lung cancer in India and reduce its incidence among non-smokers.

(By Dr. Aravind Badiger Technical Director BDR Pharmaceuticals )