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Most Lifelong Smokers Never Develop Lung Cancer—Why Not?

EnolaGaia

EnolaGaia

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It's been a longstanding medical mystery as to why 80 - 90% of lifelong smokers never develop lung cancer. New research results seem to indicate this has a genetic basis and involves long-term increased resistance to mutation in cells lining the lung's passages.
The Mystery of Why So Many Lifelong Smokers Never Get Lung Cancer May Be Solved

Smoking cigarettes is the number one risk factor for lung cancer, with tobacco products causing up to 90 percent of lung cancer deaths in the United States.

Without a doubt, the safest way to protect yourself against lung cancer is to avoid smoking cigarettes, and yet, at the same time, it's also true that not all lifelong smokers are doomed to develop cancer.

In fact, the vast majority don't. Scientists have long wondered why, and a new study adds weight to the idea that genetics has a role to play.

Among people who smoke but never develop lung cancer, researchers found an inherent advantage. The cells that line their lungs appear to be less likely to mutate over time.

The findings suggest that DNA repair genes are more active among some individuals, which can protect against cancers arising, even when cigarettes are regularly smoked. ...

The findings could help explain why 80 to 90 percent of lifelong smokers never develop lung cancer. It could also help explain why some people who never smoke at all do develop the tumors. ...
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FULL STORY: https://www.sciencealert.com/we-re-...y-most-lifelong-smokers-never-get-lung-cancer
 
It really is a mystery - Mr. R is a lifelong heavy smoker, recently cut back to one pack a day (which I still think is too much).
He worked through most of the virus and was fine, even though the huge company he worked for had employees coming down with the virus continually, and then returning when better.
Mr. R said he read that smoking helped to protect some from the virus, don't know if that is true or not, but he still believes it.
 
I read the same in an article that stated smokers statically were less likely to come down with covid. I didn't quite know what to make of it.

I've also known a few life long smokers who after packing up smoking then came down with lung cancer at a later date.
 
Ronnie Jersey said:
Mr. R said he read that smoking helped to protect some from the virus, don't know if that is true or not, but he still believes it.
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My grandmother, who would have started smoking in the 1920's, always maintained that they had been told it was good for protecting against flu and colds! She seemed to think it did (selective memory?) or perhaps she was just one of those lucky people who managed to miss them anyway?
 
kesavaross said:
I've also known a few life long smokers who after packing up smoking then came down with lung cancer at a later date.
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Same here. I know of a bloke who quit smoking 25 years earlier to be told he had terminal lung cancer, which was a bit of a kick in the teeth to say the least. However, funnily enough he was given an immunotherapy treatment which worked precisely because of a genetic mutation he has (apparently ~8% of the general population has this mutation).

He's a bit of an unusual case because he also managed to get diagnosed with skin cancer during this time (not metastatic, a different cancer) which was 'cured' with surgery, and he also had a heart attack. About 10 years prior to all of these things happening, he was diagnosed with another cancer. I can't remember what it was but it was rare and unrelated to the later cancers. Despite all of this, the last I heard he was alive and doing OK, touch wood. I honestly think he has 9 lives!

But back to topic, it's probably worthwhile to point out that smoking is linked to many cancers, not just lung cancer, and I've known quite a few smokers die from cancers other than lung.
 
What does "lifelong smoker" mean? If you start at eighteen and die of lung cancer at 21 are you a lifelong smoker who died of lung cancer or just a smoker who died of lung cancer?
I'm guessing a lot of smokers don't live long enough to be called lifelong smokers who didn't get cancer - those that do just beat the odds through genetics, luck or whatever.
 
EnolaGaia said:
It's been a longstanding medical mystery as to why 80 - 90% of lifelong smokers never develop lung cancer. New research results seem to indicate this has a genetic basis and involves long-term increased resistance to mutation in cells lining the lung's passages.

FULL STORY: https://www.sciencealert.com/we-re-...y-most-lifelong-smokers-never-get-lung-cancer
Click to expand...
We got the typical life long smokers at 102 year of age saying to media smoking and whiskey kept them going, but it was their genes which saved them.
 
My dad had a relative who we called 'Old Uncle Bill'.
He would randomly visit us on occasional Sundays and highdays.
He never had a telephone so we never knew when he would visit.

Anyways, he was a bit of a 'character' around town because he would always wear a full, navy blue, business suit and trilby hat, and he looked very similar to Winston Churchill, overweight and walked slowly with a bit of a waddle, so he was quite distinctive.
Old Uncle Bill was a 'lifelong smoker' and that was often mentioned. He smoked 'hand rolled' cigarettes, and always had one hanging from the corner of his mouth. He lived to be almost 100. Everybody expected that he must have had some kind of health issue related to smoking.
Seeing as my dad was his closest relative it was down to him to deal with Bills estate etc after he passed.
Dad specifically pursued the hospital for an autopsy report on his cause of death, which was unusual at the time, it wasn't the sort of thing that was done unless there were reasons for doing so, such as a murder, or an unexpected accidental death etc.
It took some time so when the report finally came through we were expecting it to be smoking related.
The autopsy report gave no specific cause of death though, just details of 'frailty' and other normal age-related stuff.
I remember my dad going to visit the hospital to speak to whoever had done the autopsy and coming back and telling us details of his conversation, and that he said to the chap that he was very surprised that there wasn't some mention of his years of heavy smoking and what effect it would have had on his lungs.
"Oh, if you hadn't told me he was a smoker I wouldn't have known - his lungs were clear like those of a non-smoker!" replied the doc. I remember dad telling us this like it was yesterday. Now this would have been in about 1980, when smoking was still quite common.

My dad smoked quite heavily for years and years, only packing it up in his 80s, and when he died at 87 (5 years ago) he had 'vascular dementia' which did for him in the end, but again, doc said it would not have been related to smoking.

And also my whole family have been blessed to have generally extremely good health, rarely having to see a doctor, or have a hospital visit.
I have smoked on and off through the years too and the only times I have had to visit a doc or hospital have been accident related really, except for my Fibromyalgia, but that's a different thing altogether.

Maybe it is possible to have some kind of genetic predisposition to having general good health and/or being able to deflect infection/disease??
 
Trevp666 said:
Maybe it is possible to have some kind of genetic predisposition to having general good health and/or being able to deflect infection/disease??
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I reckon so.
The thing is, it's probably dependant on many factors. For example, if you smoke in an enclosed area (room/vehicle) I would suggest that that is a lot worse for you than being outside. Also, if you are inactive, that will make a difference compared to someone who exercises regularly - and many 'physical types' do smoke, and some are also heavy drinkers - the armed forces for eg, (or they used to be- maybe it's changed now though).
 
Floyd1 said:
I reckon so.
The thing is, it's probably dependant on many factors. For example, if you smoke in an enclosed area (room/vehicle) I would suggest that that is a lot worse for you than being outside. Also, if you are inactive, that will make a difference compared to someone who exercises regularly - and many 'physical types' do smoke, and some are also heavy drinkers - the armed forces for eg, (or they used to be- maybe it's changed now though).
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I’m almost sure that genetics are the biggest factor. I recently posted that my Nan and her nine sisters (there was an eleventh who died young from TB) were all smokers for most of their lives,they all lived into their nineties and not one of them developed lung cancer. The oldest sister who died at 97 was still chain smoking sixty a day ( I know this because my aunt who lived around the corner from her used to get them for her everyday) until she went into a hospital after a fall, she never recovered and died in hospital.
I actually can’t think of any of my family getting or dying of cancer.
 
Tunn11 said:
What does "lifelong smoker" mean? If you start at eighteen and die of lung cancer at 21 are you a lifelong smoker who died of lung cancer or just a smoker who died of lung cancer?
I'm guessing a lot of smokers don't live long enough to be called lifelong smokers who didn't get cancer - those that do just beat the odds through genetics, luck or whatever.
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That's a good point, but it doesn't have a bearing on this study's surprisingly diminished correlation of sustained tobacco exposure (via smoking) with lung cell mutation rates.

Tobacco exposure is measured using pack-years - a standard calibrated such that one 20-cigarette pack smoked on average daily for 1 year equals 1 pack-year.

Mutation among the relevant lung lining cells usually increases with age for everyone throughout adulthood. Such mutations are directly correlated with lung cancer. This increase is greater for smokers than non-smokers.

The unexpected result from this study was that among smokers the rate of mutation plateaued (stopped increasing) at around 23 pack-years. This was the only group for whom the mutation rate plateaued. The implication is that there are some folks who don't face progressively increasing cell mutations (and hence higher lung cancer risks) once they survive the equivalent of smoking a pack a day for 23 years.
 
Cloudbusting said:
But back to topic, it's probably worthwhile to point out that smoking is linked to many cancers, not just lung cancer, and I've known quite a few smokers die from cancers other than lung.
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Cloudbusting has a point. Most lifelong smokers may not develop lung cancer, but what about throat cancer, mouth cancer and tongue cancer? And even COPD?
 
EnolaGaia said:
That's a good point, but it doesn't have a bearing on this study's surprisingly diminished correlation of sustained tobacco exposure (via smoking) with lung cell mutation rates.

Tobacco exposure is measured using pack-years - a standard calibrated such that one 20-cigarette pack smoked on average daily for 1 year equals 1 pack-year.

Mutation among the relevant lung lining cells usually increases with age for everyone throughout adulthood. Such mutations are directly correlated with lung cancer. This increase is greater for smokers than non-smokers.

The unexpected result from this study was that among smokers the rate of mutation plateaued (stopped increasing) at around 23 pack-years. This was the only group for whom the mutation rate plateaued. The implication is that there are some folks who don't face progressively increasing cell mutations (and hence higher lung cancer risks) once they survive the equivalent of smoking a pack a day for 23 years.
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Ah! Yes. I should have read it properly. :doh: I wonder whether the rate is different for Native Americans who have been smoking the stuff longer than other groups?

I've just been reading something that contrasted the Native American deaths from introduced Old World diseases like smallpox, measles, etc. with the number of Old World deaths caused by the introduction of tobacco.
 
Thats a good train of thought; how do we get it past the anti-smoking groups?
 
I think we've been brainwashed by the healthcare industry into believing that cancer is the inevitable fate of any living human being, and only frequent intervention by medical professionals can save us from a grisly end. If I correctly understand what I read, we all do indeed have cancerous cells in our bodies at any given time, but they are attacked and dispatched by our immune systems very handily. For cancer to escape the immune system and turn into a life-threatening illness requires a specific sequence of individually improbable events.

Yes, there are behaviors and environmental insults that increase the risk and are best avoided, but I think that, in the end, cancer is largely the result of simple bad luck
 
First off, I don't smoke. But I have wondered what the difference between tobacco smoked by indigenous North Americans vs other manufactured tobacco products.

My thought is that indigenous peoples have only, traditionally, smoked tobacco harvested directly by them and still have access to this. The manufactured tobacco is more processed with whatever the companies use (eg they can manipulate the amount of nicotine in their products).

I have definitely questioned this. Also, definitely, genetics has a play to which diseases people are more predisposed
 
brownmane said:
definitely, genetics has a play to which diseases people are more predisposed
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Exactly - genetics is major. My Dad was a heavy smoker who quit, My Mum and Grandmother smoked on occasion, I was a heavy smoker who dwindled away from it.
But I still enjoy a cigarette every once in a while, just like my Mum always did. Same thing with liquor, I can take it or leave it.
And I agree with Frasier Buddolph above, we are brainwashed about many things. Anyone ever notice one of the first things a doctor will ask is if you smoke?
 
Ronnie Jersey said:
Exactly - genetics is major. My Dad was a heavy smoker who quit, My Mum and Grandmother smoked on occasion, I was a heavy smoker who dwindled away from it.
But I still enjoy a cigarette every once in a while, just like my Mum always did. Same thing with liquor, I can take it or leave it.
And I agree with Frasier Buddolph above, we are brainwashed about many things. Anyone ever notice one of the first things a doctor will ask is if you smoke?
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Every time I see a doctor, they ask if I smoke or drink. It's as if they never read my medical history.
 
Supposedly the CBS Statistics Netherlands did a big study on smoking.

No “ sugar coating “ the results in that people who smoked cut their life by 13 years.

U.S. social security data shows smokers dying 10 years earlier than normal.

I am sure there are exceptions to these statistics.

I know a 90 year old man who grew up in the harsh conditions of the West Virginia coal mines.

This man claims people in this area usually started smoking at age 5 years and his mom and dad made sure he had cigarettes and thought this was normal.

This man is probably in better shape than I am !
 
Mythopoeika said:
Every time I see a doctor, they ask if I smoke or drink. It's as if they never read my medical history.
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LOL - our doctor retired, so Mr. R and I went to a new doctor in the area, who wants to send us for every single test known to man.
And whenever I see this woman doctor, I have to go through everything with her all over again, it's getting boring.
Cancer does not run in my family, nor in Mr. R's. If it did, I might be a bit more concerned. But I feel fine and my blood tests are great.
 
Just from family experience, I'd suggest cancer has a genetic component. By what I mean, if you are exposed to carcinogens and you don't have the genetic susceptibility, you won't get cancer. I've also been told, by nurses, not doctors, that stress is also a factor - or more accurately a trigger.

I know nothing, I'm no medico.
 
The native americans smoked pipes rather than cigarettes. I believe during the 20th century here, pipe smokers had a much smaller incidence of lung cancer than cigarette smokers. 2% vs 40% or so.
 
I have now spent about an hour on the internet, trying to find out the frequency of Native Americans smoking tobacco traditionally, for ceremonial purposes. I give up. The truth is out there! Someone please find it and post. I vaguely suspect that traditional, ceremonial use was extremely limited in terms of frequency and actual inhalation. Maybe as little as 1/5000th of a pack-a-day smoker. 1.5 commercial cigarettes a year. Also, as @brownmane pointed out, commercial tobacco products have a differrent chemical profile than the original, unadulterated tobacco plant.

Currently, NA both smoke more commercial tobacco, and have higher lung, throat, esophagus, etc., cancer rates, than non-NA in the US. We all know people who have smoked, drank, drugged, and whored for decades and lived to a ripe old age. The cumulative statistics give another story however, and I do trust the stats. I think doctors ask about smoking and drinking all the time because they are verifying one's current health practices, and that no big changes have occurred since last time. I am always glad to be asked. It means my doctor is not asleep at least for the 15 minutes of my visit.

Genetics, environmental and emotional stresses, epigenetics, nutrition, lifestyle..... That is what my oncologist used to tell me, with genetics being the biggest factor.
 
GNC said:
My uncle was a lifelong smoker, died in his 60s of emphysema.
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My Grandmother smoked Woodbines unfiltered. My Grandfather smoked Capstain Navy. Both cigarettes could strip the bark off trees. He died aged 96, she died aged 92. Both born around 1880. (That seems incredible now, that I knew people born during the reign of Queen Victoria.)

There are always individual examples that seem to be contrary to proper studies.

I've often wondered is there a weird link. Maybe those who are prone to smoking are prone to chest diseases or, going by the original study posted at the top, perhaps those who are prone to smoking are lifelong are resistant to diseases that smoking causes? Rather like those that naturally take to swimming when young are less likely to die by drowning?

Cancer went from being almost unheard of when I was young, born 1957, to being now common place. Maybe the causes of cancer are by some other reason but now amplified by modern life styles? Cancer of all types is definitely on the increase, smoker or non smoker. There must be a reason for that?
 
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