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Is Lung Cancer in the Nonsmoker a Different Disease?

Peter J. Mazzone, MD, MPH; Tarek Mekhail, MD, MSc; Alejandro C. Arroliga, MD, FCCP
Author and Funding Information

Affiliations: Cleveland, OH
 ,  Dr. Mazzone is with the Department of Pulmonary, Allergy, and Critical Care Medicine; Dr. Mekhail is with the Department of Hematology and Medical Oncology; and Dr. Arroliga is Professor of Medicine, Department of Pulmonary, Allergy, and Critical Care Medicine, The Cleveland Clinic Foundation.

Correspondence to: Alejandro C. Arroliga, MD, FCCP, 9500 Euclid Ave, G-62, Cleveland, Ohio 44195; e-mail: arrolia@ccf.org



Chest. 2004;126(2):326-329. doi:10.1378/chest.126.2.326
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Cigarette smoking is without any doubt the leading cause of preventable death in the United States. The health-related economic loss associated with cigarette smoking is approximately $157 billion, and 440,000 premature deaths occur annually only in this country.1 Worldwide, 10 million people will die annually from tobacco-attributable diseases by 2030.2 Eighty percent of the particle products of Nicotiana tabacum liberated through a lit cigarette deposit in the tracheobronchial tree. At least 55 of the > 2,000 chemical compounds identified in the tobacco leaf are proven carcinogens.3 The epidemiologic evidence accumulated over almost 6 decades since the reports of Doll and Hill45 prove an association between smoking and lung cancer. Tobacco smoke has a causal role as well in the tragic worldwide epidemic of lung cancer. Tobacco products not only cause harm to the users, but nonusers are affected as well (environmental tobacco exposure).

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