4.9 Lung cancer and secondhand smoke

Last updated: January 2017
Suggested citation: Campbell MA, Ford C, & Winstanley MH. Ch 4. The health effects of secondhand smoke. 4.9 Lung cancer and secondhand smoke. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2017. Available from http://www.tobaccoinaustralia.org.au/chapter-4-secondhand/4-9-lung-cancer-and-secondhand-smoke

Secondhand smoke causes lung cancer,1, 2 and the risk of developing lung cancer increases with the extent and duration of the exposure. For people who have never smoked and have a partner who smokes, the risk of developing lung cancer from secondhand smoke has been estimated to be 20-30%. Lifetime non-smokers exposed to secondhand smoke in the workplace also have an elevated risk of developing lung cancer, depending on the degree of exposure.2

Secondhand smoke exposure also increases the risk of lung cancer among those who smoke.3, 4

The mechanisms by which secondhand smoke causes lung cancer are believed to be similar to those observed in active smoking, where repeated exposure of the lungs to DNA-damaging material leads to multiple genetic changes that culminate in lung cancer. For smokers and non-smokers secondhand smoke exposure increases the risk of both small cell lung cancer and non-small cell lung cancer.3 Non-smokers exposed to secondhand smoke inhale a substantially lower dose of carcinogens than active smokers and have a correspondingly smaller increased risk of lung cancer.2

See Chapter 3, Section 3.4, for a full discussion of active smoking and lung cancer.


1. Office of Environmental Health Hazard Assessment and California Air Resources Board. Health effects of exposure to environmental tobacco smoke: Final report, approved at the Panel's June 24, 2005 meeting. Sacramento: California Environmental Protection Agency, 2005. Available from: http://www.oehha.ca.gov/air/environmental_tobacco/2005etsfinal.html

2. US Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_2006/index.htm

3. Kim CH, Lee YC, Hung RJ, McNallan SR, Cote ML, et al. Exposure to secondhand tobacco smoke and lung cancer by histological type: A pooled analysis of the international lung cancer consortium (ilcco). International Journal of Cancer, 2014; 135(8):1918–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24615328

4. Li W, Tse LA, Au JS, Wang F, Qiu H, et al. Secondhand smoke enhances lung cancer risk in male smokers: An interaction. Nicotine and Tobacco Research, 2016. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27107433

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