Rising Concern: 1 in 4 Lung Cancer Cases in India Occur Among Non-Smokers, Say Doctors

BENGALURU | August 1, 2025: Lung cancer is no longer a disease confined to smokers. Up to 25% of lung cancer cases in India are now being reported in individuals who have never smoked, and some Indian studies estimate this number could be as high as 40%. Medical experts point to second-hand smoke, indoor air pollution, occupational hazards, and hormonal factors as key contributors.
Speaking on the occasion of Lung Cancer Day, Dr. Radheshyam Naik, Head of Medical Oncology, Hematology & Bone Marrow Transplantation at Sammprada Hospital, Bengaluru, highlighted the growing burden of lung cancer in Indian metros. “Over the past three decades, we’ve seen a steady rise in lung cancer cases across cities like Delhi, Bengaluru, and Chennai — affecting both men and women. Factors such as smoking, worsening air pollution, and improved awareness leading to early detection have contributed to this trend,” he said.
Dr. Naik emphasized that exposure to carcinogens through second-hand smoke, indoor pollutants from the burning of solid fuels (wood, charcoal, cow dung), and occupational environments are major risks for non-smokers. “India ranks fifth globally for air pollution. Nearly half of Indian adults are routinely exposed to second-hand smoke at home, workplaces, or during commutes. Indoor air pollution alone accounts for 4–6% of the country’s lung cancer burden. Alarmingly, 75% of Indian households still rely on solid fuels for cooking,” he noted.
He further added that long-term exposure to incense smoke in poorly ventilated indoor spaces also poses a significant risk. “People who have burned incense indoors for over 40 years face a fourfold higher risk of lung cancer compared to other non-smokers,” he said.
Dr. Vinod K Ramani, Consultant – Preventive Oncology at Sammprada Hospital, explained that both smokers and non-smokers in India are often diagnosed at advanced stages of lung cancer due to overlapping symptoms with tuberculosis. “Persistent cough, chest pain, and weight loss are common to both TB and lung cancer, often leading to misdiagnosis and delayed treatment — particularly in early-stage cases,” he said.
Treatment options for lung cancer today include immunotherapy, targeted therapy, and post-surgical cancer vaccines aimed at preventing recurrence. Dr. Ramani advised that family members of cancer patients should consider themselves at elevated risk and watch for warning signs such as chronic cough, blood in sputum, or unexplained weight loss. “Non-smokers should undergo regular screenings. A full-body MRI every three years is a good preventive step,” he added.
Offering preventive advice, Dr. Vishwajeeth Pai, Consultant – Medical Oncology at Sammprada Hospital, said individuals should wear pollution masks when outdoors in poor air conditions and avoid inhaling emissions from fossil fuels. “Using LPG for cooking rather than for driving vehicles can reduce indoor pollution. Also, homes should be tested for radon gas, a naturally occurring radioactive substance that seeps from underground soil and can significantly raise lung cancer risk,” he cautioned.
With environmental and lifestyle-related factors increasingly contributing to lung cancer, especially among non-smokers, doctors stressed the urgent need for awareness, timely screening, and clean air practices to tackle this growing public health challenge.
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