> Over 50% of Asian American women who have lung cancer have never smoked
Is this really that surprising, considering that only 2.6%[1] of Asian American women smoke? If 0% of Asian American women smoked, then 100% of the lung cancer cases would come from non-smokers. As it is, the group with the lowest percentage of smokers should have the highest percentage of lung cancer cases in non-smokers.
The article gives no absolute rates to compare, and I can't easily find the article they quote for the rising rates of lung cancer in Asian American women. Given the poor interpretation of the subheading, I wouldn't be surprised if it was entirely explained by aging, or was a reversion to the mean from a very low baseline.
Exactly!! The article doesn’t even get the paper right, but the paper doesn’t even talk about actual incidence rates within the non smoking population!
12% of Asian American men smoke compared with 2.6% of women. So non smoking Asian women are more likely to live with a smoking man. Could second hand smoking exposure be a factor in this?
This is what I first thought of as well, but other sources indicate that Asian Americans are actually the demographic with the least overall cigarette use[1]. Given that White and Black Americans use cigarettes at almost twice the rate Asian Americans do, we'd expect strong second-hand correlations for those groups as well.
(This source doesn't quantify "use," so there are confounding factors: prevalence of smoking at home, chain smoking vs. social smoking, etc.)
Not sure about the validity of the source but it does suggest that second hand smoke could be related.
"What’s behind this rise in lung cancer in women who have never smoked compared with men, and particularly in Asian American women? One possibility: While Chinese American women may never smoke themselves, they frequently live with partners or family members who do. (About 28% of Chinese American men smoke heavily, Dr. Li said.) “We think secondhand smoke might be one of the key risk factors, because they’re living with people who smoke,” Dr. Li said." [1]
I could see a possible scenario where a first generation (i.e. immigrant, English as a second language) Asian father/husband smoking at home in the 1990-2010 timeframe and not getting the second hand smoking messages/ads (that were primarily in English as quickly) as the rest of Americans and it's is just now that the statistics are showing up.
IIRC the lifetime risk of lung cancer for smokers is more like 20%. For reference, among non-smokers the risk of lung cancer[0] is about 1%. So smoking is represents a 20x increase in risk.
Around 80% of lung cancers are found in smokers and another 10% with heavy exposure to second-hand smoke. Smoking is the single largest risk factor for lung cancer.
[0] All numbers are based on general population of US, so heavily white-skewed, I dunno about asian americans specifically.
I suspect part of this is because smokers, generally, don't always live long enough to actually get cancer, and statistically their year-over-year cancer risk drops to the same as the general population when they do quit.
However, COPD, once established, is irreversible.
My dad was a long time smoker and it was COPD that eventually got him. He battled it for years after he quit.
this is correct. it's clear that smoking elevates cancer risk, but why doesn't it cause cancer in all smokers?
to develop a cure, we must better understand the causal mechanisms.
this starts with acknowledging what we know and don't know about a devilishly complex disease that is arguably better conceptualized as a broad category rather than one monolith -- similar to how the flu, cold, and covid could be grouped under one mega classification, but are better identified as distinct conditions.
I think we understand the causal mechanism pretty well. it is just laypeople struggle with binary thinking vs probability.
The reason why only 20% of smokers get cancer is similar to why a person doesn't get cancer after 1 cigarette.
This is only counterintuitive if your default thinking is that smoking=cancer. In reality, there are a lot of variable chemical and biological processes involved, but ultimately it ultimately boils down to a cumulative risk, not guarantee.
Longer answer: Logically, the answer should be zero, but it's actually not that simple to categorise either 'non-smokers' or 'a smoking-related illness'.
Taking lung cancer as an example, approximately 10-20% of lung cancers occur in folks who are non-smokers (defined as 'never' or 'fewer than 100 cigarettes in their lifetime'). Researchers estimate that of these, around 20% are caused by second hand smoking, meaning that around 8-16% of lung cancers are non 'smoking related' in non-smokers. Not all lung cancers result in death.
So if we take the same approach, and consider the 80% of lung cancers which occur in smokers, presumably similarly 10-20% of those would have developed lung cancer regardless of whether they smoked or not, so potentially we would need to say that less than 65% of lung cancers are caused by smoking.
Is it then fair to call lung cancer a 'smoking-related illness', if more than a third of people who develop lung cancer did not do so because they themselves smoked[0] (the number changes to 70% if we consder the folks who hypothetically develop lung cancer due to second-hand smoking as 'smoking-related').
There are also a lot a problems with the methodology here. How do we know whether someone really smoked 100 cigarettes or fewer? Is there any statistically significant difference between people who smoked 100 and 1 000? 100 000? Does it matter if someone smoked all of those 10 000 in the last year (almost 30 a day) or whether they smoked those 10 000 over the past 50 years (less than a pack a month)? All of these things seem to my mind to be problematic and make it impossible to answer your question.
However, perhaps I wasn't critical enough in my reading, and instead simply parroted the stat.
[0]: big caveat here is that my ramblings don't consider the possibility that a 50 year-old who would otherwise have developed lung cancer at 80 develops lung cancer as a result of smoking, and lung cancers caused by smoking stop lung cancers developing from other causes.
Thanks for the considered reply, I've searched for the answer myself and never had any luck. It is strange that all of these studies confidently announce the one percentage and never mention the other, and without the latter, the former seems meaningless.
Yes, but as far as risk factors for lung cancer, second-hand smoking is one of the better known.
I don't immediately see Asian American women being exposed to additional regional air pollution, asbestos, coal soot, or radon more than others.
There could be a race-linked genetic factor, but I'm not aware of Asian women that are non-American having a higher rate. So I don't see why it would be something like... aspirated cooking oils fumes or natural gas fumes while cooking. Do Asian American households have a significantly higher likelihood of natural gas stoves? Do they have cultural histories of certain kinds of make-up or body treatments like talc?
The article indicates a 260% increased all-factor risk for never-smoking Asian women, compared to White women. There has to be more going on than just second-hand smoke exposure.
I mean, it’s not going to be 0/10 because smoking causes cancer.
Cancer itself isn’t deterministic. This isn’t news. There is virtually nothing that is 100% guaranteed to produce cancer, but there are things that massively increase risk. Tobacco is one of them.
Anecdotal but can confirm that my Asian dad smokes a pack a day, with the window open, and it pretty much permeates the apartment, and we've all had issues with lung health. There's no doubt in my mind this is a huge factor.
Sidenote but I haven't missed my father since I left home. Traditional old Asian men are possibly the worst humans ever.
I'm assuming they are referring to "traditional old Asian culture" aka the combination of old patriarchal/sexist beliefs, a toxic workplace/exploitation culture, society-over-individual attitudes, and that topped up with a healthy dose of racism to xenophobia (depending on the country).
I mean, some of this is rich to talk about given I'm European and most Western countries share a lot of these traits, but from what I hear(d) from friends from Asia, it's the "the needs of the society/family are more important than those of the individual" that they find the worst compared to the very individualist attitudes of Western countries.
Oh, absolutely, and it can be seen for example in suicide rates [1], or the weird state of Japanese criminal justice where prosecutors will only go for nailed-shut cases so that they don't "lose face" (while society as a whole suffers) [2], not to mention the entire issue surrounding "forced confessions".
By definition, negative side effects that can be cherry-picked are more numerous and pronunced in an Individualist society, as the very point of Collectivism is to steer the crowds away from trouble, while Individualism tolerates a wider range of individual tragedies for the potential upside.
Your examples were not well chosen anyway, as their relation to collectivism seems dubious, and US prosecutors also have high conviction rates without trial through threat of big punishment.
yes of course, the enlightened Americans are so much better at handling crime. pointing at western justice systems to say that western values are superior - this must be satire?
This seems like an uncharitable reading. I don't think there was a comparison made.
Any justice system with a very high conviction rate is either unjust or extremely selective. The American federal government is also extremely selective in prosecution, and for the same reason. Losing makes the prosecutor look bad.
East Asian wars tend to be drastically more deadly than the wars of any other group. The Three Kingdoms War wiped China's population to 30% of what it once was, and had half the deaths of WWII in a world with two hundred million people instead of billions.
"Society" in this context can also mean "a tiny number of primarily self-interested individuals". That tends to be evident when the most powerful or influential people also happen to be strict authoritarians.
Individualism in western countries varies quite a bit. In cross-country scores, Spain has numbers far closer to the middle east than to the US, and then Peru is closer to China than to Spain!
So your invdidualism argument is only strong if by western, you mean the anglosphere, the Netherlands and Belgium.
Even within China, the north (wheat-growing culture) is noticeably more individualistic than the south (rice-growing culture). The south is also significantly more traditional.
Japan and Korea, despite being in North-East Asia, are rice-growing, due to their oceanic climate. Culturally they are also closer to Southern China.
A shallow and superficial comment in a subthread that took the wrong turn. Casually applying nasty labels in an act of self-loathing from a fellow German. Oh no, our toxic workplaces, truly funny. Our beloved individualism that has little regard for society as a whole left, consequences of that showing up more and more, how dare the old asian guy hold on to the old ways. "Xenophobia" in the face of mass immigration that is handled terribly etc.
Actually take your criteria and apply them fairly to some of the other cultures around the world. And let the old guy smoke (outside). He is not the worst human ever, that's for sure.
I remember when I was a kid one of my friends telling me he hated his parents. How old are you in the 8th grade? 13, 14? That's how old we were. I'm sure I didn't say anything - what could I say? - but it seemed totally incomprehensible to me. It would be as if he had said he hated himself. How could you?
My parents aren't saints. They're no less human then I am. Like my wife and my kid they're people that are so easy to forgive. It's so easy to rationalize away anything they do. It's just tiny bit easier to forgive myself then them and I don't see how it could be otherwise.
Yeah but this should be the same increase in diagnosis amongst other non-smokers, or closer
My hypothesis would be environmental plus genetic, given that our east Asian phenotype population is small and consolidated to small areas of the country. NYC, Socal
Maybe we should look at increase in lung cancers in those areas specifically
I am sure this inevitably is going to blame Asian cooking, but one important factor here is that the women surveyed were 40-70 year old. It is important, because a huge portion of these women would be first generation immigrants. That is important to know because first generation immigrants from decades ago are more likely to have a lower socioeconomic living conditions. Life in Asia with higher pollution and lower safety standards, life in America in poor neighborhoods with exposure to pollution, asbestos, and other carcinogens are all likely contributing factors.
Cooking on a gas stove without proper ventilation is terrible for you. My stove didn't have a hood when I moved in, inspection didn't even call it out to fix. But I started getting dizzy and feeling sick in my house; and had to install air sensors before I realized it was cooking that was absolutely destroying my air quality. Like from 2ppm to 1000ppm down the hall in the office.
The whole "they're coming to steal your stoves" thing started for a reason, without proper ventilation to the outside (which just isn't that common in the US), cooking can destroy your lungs, even today.
Wasn't there something about some seed oil fumes being toxic? Maybe it's related to some cooking practices. Highly speculative but the cooking oil toxicity is well-known.
[edit 2] and indeed the article mentions it, although just in passing, still my hunch would go towards this as it seems a more specific factor than the others that are mentioned
While this is definitely a possible explanation, I would hesitate to jump to any particular conclusions until further research is done on specific risk factors. The article also mentions air pollution as a possible cause:
>For example, a 2019 study found that Asian Americans breathe in 73% more tiny pollution particles than white Americans, most likely because of greater exposure to construction, industry and vehicle emissions where they live.
As you mention, there is some preliminary research which suggests cooking oil smoke could be related, but this is far from enough to definitively point towards it as the root cause, or even enough to justify your hunch I would argue. Also keep in mind there could be multiple causes of which cooking oil is just one part.
Very empirical, but earlier this year I was talking to a Thai street food cook who mentioned he was scared of getting cancer from the cooking fumes, because he knew many people who were also cooks and got ill.
Mustard oil is rich in unsaturated fatty acids, but it also contains a special type of fatty acid called erucic acid, which lies at the center of the controversy surrounding the oil. Seeds from the brassica family of plants, which includes rapeseed and mustard, in addition to cabbage and kale, all contain varying amounts of erucic acid. Early experimental studies on animals in the 1950s suggested that erucic acid possibly had a role in the development of heart disease.
They use caiziyou, AKA roasted rapeseed oil, which has a high level of erucic acid, similar to mustard oil. (Rapeseed is a member of the mustard family. Canola is low-erucic acid rapeseed oil.)
Rapeseed oil for cooking is a staple in Germany.
If erucic acid or its thermal products are the cause, there would also be many cases of lung cancer in Germany.
Mustard oil and mustard gas are only related by color. Mustard oil is made from mustard seed. Mustard gas contains sulfur and nitrogen mustards which are yellow.
Absolutely! Having only gotten into a house with a well done vent going outside recently, it is alarming how much cleaner everything in the kitchen is. Heck, I'm pretty sure the entire house shows signs that we don't have as much oil residue as we had in our previous houses.
Now... there is also the eye opener that is cleaning the range hood for the first time. Holy crap.
Yes, and having installed one myself, its no picnic so I can understand why there would be a pushback against that and instead scapegoating the gas range. But really its insane how much crap gets into the air when you cook anything indoors on any type of range.
Seed oils mainly, a factor of the lower smoke point. The only suitable plant oils in this regard are olive and coconut oil - which are fruit oils.
[edit] seed oils r bad skeptics can just double check - the top 3 highest smoke point oils are all fruit oils, with seed oils at a distance - with the exception of peanut oil, which is closer.
The smoke point is also not the only relevant factor, the fatty acid makeup is also important, high omega-6 oils are more likely to oxidize, coconut oil for instance is high in saturated fat, olive oil is mainly monounsaturated.
Smoke point is a measure of when obvious quantities of particles are emitted, not their chemical composition. Extra virgin olive oil has lower smoke point than refined olive oil, but it's more chemically stable under frying conditions:
Yeah but it's about what the chemicals turn into when they reach a certain temperature, seed oils probably have something in them that is chemically different
See edit, it's indeed a factor of both fatty acid makeup and smoke point. Seed oils tend to have more PUFAs which oxidize easily. Olive oil, on the contrary, is not only mostly monounsaturated but also contains anti oxidant compounds that are protective (I think oleic acid, and others)
Soybean oil is mentioned in the study. A lot of people get very angry when seed oil dangers are mentioned, it's hilariously politicized, the fact is these are not lindy at all, there is no tradition that would validate their safety, these are 20th century inventions.
I am equally confused. I think there is a dumb but somewhat worrying trend of people's political identity becoming so pervasive that it absorbs secondary and tertiary opinions about completely unrelated things.
Yes, a large segment of conservatives have taken the place that previously left-wing hippies occupied wrt skepticism of mainstream health advice, and seed oils is a major subject, I would say even iconic, with places like Reddit vehemently disagreeing and calling it anti-science or whatever. I agree that it's unfortunate, but currently this previously left-wing impulse to favor "natural", "unprocessed" products is predominantly found in right-wing circles.
Yeah this is a really weird shift that has happened in a relatively short time. In Sweden we have strange groups of nazis and hippies that you wouldn’t have thought would happen in a million years when I was a kid in the 80s/90s.
> Seed oil avoidance is right-wing coded, it's undeniable.
Even taking that claim at face value, "right-wing coded" is hardly the same as "hilariously politicized". Living in rural areas is right-wing coded as well[1], but nobody would seriously call it "hilariously politicized", especially when you consider the broader context of the phrase:
>A lot of people get very angry when seed oil dangers are mentioned, it's hilariously politicized
Back in Thailand she and her mother often used coal for cooking (which is listed in the article as a possible cause) but after moving to Australia, she no longer used it because it is impractical (the coal is hard to find, the type of stove used for cooking with coal is not readily available, neighbours would complain about the smoke, etc etc).
I imagine that most other Asian women who migrated to Western countries face a similar situation and no longer use coal on a daily basis.
Also, I am sceptical that cooking oils could be a factor, it seems to me that, at least in the parts of Asia where I have lived, the types of cooking oils used are similar to the ones used in the West. I have seen the comments about mustard oil but its usage seems to be limited to certain countries or regions and not widespread everywhere in Asia, whereas according to the article, the issue affects women from various countries from India to China.
EDIT - however some of the comments indicate that other oils, not just mustard oil, also present similar health challenges and they are widely used in several Asian cooking traditions.
I think the difference in cooking oil is in how the oil is used. What I hear abour Chinese households in US is that their kitchens tend to become more greasy, because their cooking style tends to produce more oil fumes, and fume extractors tend to be less common in US than in their home countries.
It's worth noting in this context that Asian-American women are by far the longest-lived demographic group overall. Asians have a combined life expectancy of 86 years in the US, and women generally have a 4-5 year advantage relative to men.
> A study of nearly 4,000 non-smoking women found that the share of Asian American women who developed lung cancer was more than twice that of white women.
And then proceeds to list "53.4%" for Asian.
Are we to believe that in a sample of "nearly 4,000 non-smoking women", over half of the Asian American women developed lung cancer?
Elsewhere in the article it is said that
> Among Asian American women who have lung cancer, more than 50% have never smoked"
Those seem like completely different things to me...
My interpretation of the underlying study is that 53.4% of the asian women who developed cancer in the study were nonsmokers, which I believe is subtly different from what you said.
But I think what NBC wrote on the graph is pretty unambiguous, that 53.4% of nonsmoking asian women in the study developed cancer. They titled the graph "Lung cancer among nonsmokers, by race" when it should really be "Nonsmoking among Lung Cancers, by race".
Or do you think between the title, caption, and data, their chart is presented in a way that can be argued is correct? It doesn't seem like it to me.
Actually, I did use the table you posted to validate my interpretation was correct before I posted it. Searching for the string "53.4" will direct you to the following:
female incident lung cancer cases
smoking status
total never ever unknown
Asian | 296 (7.7) 158 (53.4) 103 (34.8) 35 (11.8)
It's a lost cause. No one labels charts correctly when presenting complex conditionals breakdowns. It's impossible to cram the proper grammar into the brief titles.
I think your interpretation is correct, but I'm not convinced it's just a matter of ambiguity. It looks to me like the caption on the graph is stating something that simply isn't true.
You're right on the graph. The graph in the article is very misleading, especially the N=4000 non-smokers.
If you look the table in the source paper, 53.4% of 296 Asian American Female (Single Group) lung-cancer patients are non-smokers.
Also, share of lung-cancer patients being non-smoker vs. smoker being higher in Asian american females, does not necessarily mean they're more likely to get lung-cancer. This assumes the non-smoking vs. smoking population is the same in teh general population, which it isn't.
I see a lot of comments being made on here that are highly speculative of actual Asian American culture coming from users who - from their post histories - are not Asian. It's a lot of hearsay, and none of it is lived experience. The views that we "smoke behind our parents backs", or "burn a lot of incense", or "cook with a wok" are dated and archaic takes on what our lives are like. To the users making these comments - have you ever been in an Asian household?
"burn a lot of incense" is a first hand experience here. Not a one off. You can't really tell me I imagine that. It's hard not to notice or even avoid.
The first thing that popped into my mind is that in the city nearest me, Chinatown was bisected by a freeway back in the 80s (opening in 1991). That'll be a bunch of new carcinogens in the air concentrated around that specific neighborhood.
I have a bizarre theory that 1 - 1.5 packs of cigarettes per year is actually beneficial for health. This theory has two parts:
- small amounts of nicotine occsaionnaly are excellent for the brain
- the innoculatory effects of small occasional acute exposure to toxins and carcinogens preemptively activates and trains your body and its immune system to respond to the types of things that cause damage. Basically by activating the damage repair systems occasionally under a mild stressor you keep yourself inoculated against seemingly damage-associated conditions.
I'll let y'all know how it's going in 200 years or so :)
I have a similar theory about car accidents. I get in one every couple of years because I think that I'll be able react more quickly to them if I'd never experienced it at all. :-).
Slightly more seriously, I hope your cigarette plan works out for you.
Really? You need widespread exposure to build your immune system. That’s what I thought. Haha
Though truth be told, I did read your comment as sarcasm, supportive of my position or humorously mocking the outrageous comparison example of car accidents ha ha
I mean, if you told me you were doing a defensive driving course i’d be like hell yeah!
You know that would keep your skills sharp, and the accidents would be a result of those stressors.
Haha. I suppose the obvious difference is a car “accident” depending on how controlled it is could kill you. Whereas a handful of cigarettes is not going to kill you.
The driver of the road train bringing groceries up the west coast highway flicked a cigarette out the window that blew straight back in and into his eye causing him to over steer a roll a prime mover and two trailers.
You're correct that it didn't kill him, but it was a close call that could've gone that way.
Oh hahahah. That's a great story, but I think you might be missing the point of taking a cigarette. Hahahah! :)
Ah the endless interactions between between vehicles and cigarettes. Don't know why this came to me but in Taiwan, a massive rail tragedy was caused when a utility truck for some kind of maintenance rolled backwards down an embankment and onto a rail line at the mouth of a tunnel. The train was either entering or exiting (I forget which) and dozens of people were killed. All because a much smaller vehicle parked unsafely or forgot the handbrake!!!
(Ignore the downvotes this will likely get. People seem to knee-jerk have an issue with me saying anything at all about health. It's meaningless noise.)
I guess that makes sense. I mean I'm not depressed and I never have been but I know that cigarettes gave stability to a lot of friends I had when younger who had those kind of issues. Less likely to fall off the deep end and probably kept them more functional and taking care of themselves.
Does it make them less depressed?
As an aside on the downvotes: i mean, whatever works for you! People downvote but they're not you, and your body is gonna be unique. Everything can work differently for different people.
Interesting. Not sure what to make of that, brain is not quite optimal right now but I guess those systems are connected.
Probably depression is a complex thing with distinct pathologies covered by one word that can’t capture all the causes, even tho symptoms overlap across distinct types. Gut brain important too.
Everyone’s different. I didn’t get COVID but my spouse got it and we lived in a very dense part of the world during it. Before taking a crowded train my body would crave a cigarette, not for the anxiety, would be like the night before, but I figured out it was warming up my immune system. Maybe the oxidative chemicals in the smoke also kill virus and bacteria too. I very seldom get halitosis but I find a cigarette knocks it out and it doesn’t come back. Everyone’s different tho which is also science: epigenetics etc.
I think occasional tobacco aligns with its historical use as a shamanic or medicinal herb. I love the nicotine high but I’ve never been addicted compulsively so I never got into it, but occasional is good. Track my health across years where I have a couple cigarettes versus none at all and it’s better in those moderation years. Very occasional is good for my qi too.
It’s funny tho that CDC admits it improves depression in some. Haha
I guess we should start breaking down Asia, not just lump everyone into this demographic. People here are confused between South Asia, Southeast Asia and East Asia, there may be some overlapping similarities but culturally it is vastly different.
soybean oil is definitly the main differentiator and one of the most toxic oil there is and wouldnt be surprised that high smoking it increase risks of lung cancer. asian women being the cooks in most traditional family there you go… I am myself asian and totally stopped using it. I also suspect chili to be the reason regions like korea have high intestine/colorectal cancer
No, they're smoking behind their parents backs when they're young, and they're not telling their doctors, because Asian Americans, like many minorities, tend to patronize doctors of their own ethnicity and those doctors know their parents.
Start doing autopsies on them - oh wait that's forbidden in their culture.
Very glad to see some people trying to do some research on this population cohort of Asian American women who never smoked.
It would help if we had a clearer idea of what cancer is. Some cancers are known to be caused by viruses. Maybe someday they will have clearer distinctions between viral cancers and other cancers and that will help solve mysteries like this one.
I'm frankly surprised by this. The only thing I had ever heard of was the Japanese smoking paradox where Japanese people smoke at higher rates and have lower rates of lung cancer. How or if that relates to this, I don't know.
Is this really that surprising, considering that only 2.6%[1] of Asian American women smoke? If 0% of Asian American women smoked, then 100% of the lung cancer cases would come from non-smokers. As it is, the group with the lowest percentage of smokers should have the highest percentage of lung cancer cases in non-smokers.
The article gives no absolute rates to compare, and I can't easily find the article they quote for the rising rates of lung cancer in Asian American women. Given the poor interpretation of the subheading, I wouldn't be surprised if it was entirely explained by aging, or was a reversion to the mean from a very low baseline.
[1] From another comment on this article: https://www.lung.org/quit-smoking/smoking-facts/impact-of-to...
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