Secondhand smoke (SHS) exposure is unsafe for everyone, but did you know that it can be especially dangerous for people with lung cancer? We sat down with Oladimeji Akinboro, M.D., M.P.H., Fellow, Hematology/Oncology at Boston University Medical Center to discuss what is known about the impacts of secondhand smoke exposures on lung cancer patients and what still needs to be discovered.

Lung Association: What are some of the harms of SHS for people with lung cancer?
OA: It is well documented that exposure to SHS can cause lung cancer. So it is best for people to avoid smoking and being around smoke whenever possible. In terms of the harms for people who already have lung cancer, the published data is among those with non-small cell lung cancer (NSCLC). NSCLC is the most common type of lung cancer, accounting for about 85 percent of all lung cancer cases. Among patients with NSCLC who are exposed to SHS after diagnosis, their overall and progression free survival is reduced. This means they are more likely to have their lung cancer progress and die from their disease than those who have not been exposed to SHS on an ongoing basis.

Lung Association: What is the impact of SHS on lung cancer treatment?
OA: While there isn't direct evidence yet regarding the impact of SHS exposure on lung cancer treatment, there is evidence that smoking during lung cancer treatment reduces the effectiveness of treatment and can make radiation and chemotherapy more toxic. Basically, tobacco smoke has many harmful chemicals and one of the best ways to keep your lungs healthy is to avoid it as much as possible.

Lung Association: What are some challenges to studying SHS and lung cancer outcomes?
OA: Generally during doctor’s visits, physicians and oncologists ask if the patient smokes but they don’t ask about SHS. Things like SHS are never addressed and that is a problem and one reason why it is difficult to capture the effect on SHS on lung cancer outcomes. Measurement is also a challenge. We don’t have the specific data on the dose response relationship that we have established with cigarette smoking. This means we don’t know exactly how cancer outcomes are worsened by exposure to different amounts of SHS.

Lung Association: What are some of the most important points lung cancer patients need to know about SHS?

  • SHS will negatively impact your survival outcomes if you have lung cancer.
  • Lung cancer patients should tell their loved ones who smoke, “I need your support as I go through treatment and would like to ask that you not smoke around me.”
  • Just like not complying with your treatment regimen, exposure to SHS negatively impacts your treatment outcomes.
  • Getting involved in advocating for clean indoor and outdoor air policies is also a great way to help reduce exposure to SHS for the general public.

Please join our fight for smokefree air and lung health by becoming a member of our Lung Action Network.

For patients and caregivers seeking more information about lung cancer, visit

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