Tobacco & Vaping

Asbestos & Smoking as Causes of Lung Cancer

If a person with lung cancer had both a significant smoking history and asbestos exposure history, which exposure caused the person’s lung cancer? The answer is both cigarette smoking and asbestos.

asbestos smoking lung cancerIt is well known that lung cancer is primarily caused by cigarette smoking. However, many people do not realize that asbestos exposure is also an established cause of lung cancer. Studies showing that asbestos causes lung cancer date back to the 1940s and 1950s. For example, a study by Sir Richard Doll in 1955 found that asbestos workers were about 10 times more likely to develop lung cancer as compared to people who had not been exposed to asbestos1.

If a person with lung cancer had both a significant smoking history and asbestos exposure history, which exposure caused the person’s lung cancer? The answer is both cigarette smoking and asbestos. This very issue was discussed in a landmark study in 1968 by Drs. Selikoff and Hammond2 entitled, “Asbestos Exposure Smoking and Neoplasia.” Prior to this study, it was known that both smoking and asbestos were both causes of lung cancer. What Selikoff and Hammond demonstrated is that when the lung cancer risk from smoking is combined with the lung cancer risk from asbestos exposure these separate risks multiply and produce an extraordinary high risk. Drs. Selikoff and Hammond stated, “There is an extraordinary risk of developing and dying from lung cancer for asbestos workers who smoke cigarettes regularly. In the group studied the combination of asbestos exposure and cigarette smoking increased the risk approximately 90 times compared with men who neither work with asbestos nor smoke!”

The combined effect of cigarette smoke and asbestos exposure on the risk of lung cancer is known as a “synergistic effect” or synergy. In a follow-up study in 19793, Drs. Hammond and Selikoff concluded: “Evidence from this study indicates a strong synergistic effect between two types of exposure (asbestos dust and cigarette smoking) in respect to risk of lung cancer.”

In 1997, experts from around the world met in Helsinki, Finland, and published a consensus report4 establishing a criteria for determining when a lung cancer could be attributed to asbestos exposure. This group of international experts concluded that all major types of lung cancer can be caused by asbestos, including squamous cell, adenocarcinoma, large cell and small cell lung cancer. The group also concluded that 1 year of heavy asbestos exposure can double the risk of developing lung cancer. Although certain experts for asbestos companies in asbestos litigation contend that a person must have a diagnosis of asbestosis to attribute a lung cancer to asbestos exposure, the Helsinki consensus report concluded that a diagnosis of asbestosis is not necessary and concluded that: “Cumulative exposure, on a probability basis, should…be considered the main criterion for the attribution of a substantial contribution by asbestos to lung cancer risk.” In other words, a lung cancer can be attributed, at least in part, to asbestos exposure based on a worker’s asbestos exposure history.

The fact that cigarette smoking is clearly a major cause of lung cancer does not change the fact that asbestos exposure is also a cause of lung cancer. There can be no doubt that asbestos is a cause of lung cancer. In fact, the United States Government has recognized this fact time and again. For example, in 1986, the Occupational Safety and Health Administration (OSHA) concluded that, of all diseases caused by asbestos, lung cancer constitutes the greatest health risk for American asbestos workers, and that lung cancer has been responsible for more than half of the excess mortalities (deaths) from asbestos. In 1986, OSHA also concluded that lung cancer can result from low cumulative exposure to asbestos5. On the issue of smoking and asbestos exposure, OSHA also concluded, that asbestos exposure contributes to almost 80% of lung cancer deaths even among workers who also smoked.

Levy Konigsberg LLP (LK) has represented people in asbestos lung cancer cases for more than 25 years and has obtained some of the largest jury verdicts and settlements in lung cancer cases, in which both asbestos exposure and cigarette smoking was a cause. LK is also one of the only asbestos law firms to have also won a lung cancer case against a tobacco company. Based on its track record of success, LK was recently named the Plaintiff Product Liability Law Firm of the Year for 2013 by U.S. News and World Report. Lung cancer attorneys at LK are educated on the legal and medical aspects of lung cancer and use this expertise in the prosecution of lung cancer cases. To speak with a lung cancer lawyer at LK, call 1-800-637-6529 or submit an online inquiry on this website using our live chat or email form.


1 Mortality from Lung Cancer in Asbestos Workers by Richard Doll, British Journal of Industrial Medicine, 1955, 12, 81;

2 Asbestos Exposure, Smoking and Neoplasia, by Irving J. Selikoff, M.D., E. Cuyler Hammond, Sc.D. and Jacob Churg, M.D., JAMA, April 8, 1968, Vol. 204, No. 2;

3 Asbestos Exposure Cigarette Smoking and Death Rates, E. Cuyler Hammond, Irving J. Selikoff and Herbert Seidman, Annals New York Academy of Sciences, 1979;

4 Asbestos, asbetosis, and cancer: the Helsinki criteria for diagnosis and attribution, Scand J Work Environ Health 1997; 23:23:311-6;

5 Occupational Exposure Asbestos, Tremolite, Anthophyllite and Actinolite, Occupational Safety and Health Administration (OSHA), June 20, 1986, 51 FR 22612-01, 29 C.F.R. 1910, 1926.

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