Vaping, hookah and heredity: The new-age triggers for lung cancer

Traditional risk factors like smoking cigarettes, being exposed to asbestos, or having air pollution for an extended period of time have long been linked to lung cancer . But as new-age triggers like vaping , hookah use, and genetic risk start to gain traction, particularly among younger people and non-smokers, the discourse is changing.

Vaping: An unspoken risk
Vaping is being marketed as a less harmful alternative to smoking cigarettes, and it has swiftly gained popularity among young adults. Many researchers now say that vaping is not harmless by any means. Vaping has been found to contain nicotine, formaldehyde, volatile organic compounds, carcinogens and other poisons that are aspirated into the lungs during vaping. These substances damage lung tissue, cause inflammation, and increase the likelihood of stimuli creating cellular changes that can also contribute to increases in lung cancer.

In addition, a number of vaping liquids have flavorings that give off toxic by-products when heated. Studies are exploring if vaping suppresses lung immune function worsening the damage of the lung tissue that leads to future cancers.

Hookah: Not a safe alternative
Hookah is commonly, as a social and accepted way to smoke tobacco, popularly misinterpreted to be less harmful than smoking cigarettes. However, a hookah smoking session can involve inhaling 100-200 times the volume of smoke of smoking a single cigarette (Blue 219).The smoke also contains tar, carbon monoxide, heavy metals, and other chemicals linked to the causes of cancer.

Due to the fact that hookah smoking normally involves a longer period of time, the increased exposure to toxins may prove to be even more lung-threatening. The social aspect of hookah also makes it more likely to catch respiratory infections, which further weaken lungs.

Heredity: The forgotten risk
Although lifestyle continues to be the primary cause of lung cancer, genetics are also a significant contributor, particularly in non-smokers. A person with a family history of lung cancer can have genes that predispose them to lung cancer, even without apparent environmental causes.

In a few instances, hereditary lung cancers are associated with EGFR (epidermal growth factor receptor) mutations, which occur more frequently in younger, non-smoking Asian women. Detection of genetic susceptibility by tumor testing or family screening is becoming a significant component of individualized cancer treatment.

The face of lung cancer is changing. It's no longer just about long-term cigarette use; newer lifestyle choices like vaping and hookah, combined with genetic predispositions, are expanding the at-risk population. Awareness, early detection, and preventive action — including quitting harmful habits and undergoing genetic counseling when needed — are essential in tackling this evolving public health challenge.

Dr. Rajesh Mistry, Senior Director (Group), Oncology, Kokilaben Dhirubhai Ambani Hospital, Mumbai