Written By: Daniel King,
Last modified: January 19, 2022

Smoking is the leading cause of preventable death in the U.S. Cigarettes and other tobacco products contain dozens of toxic substances that can cause cancer, and tobacco smoke also weakens your lungs, making you more susceptible to respiratory diseases. The combination of smoking and asbestos exposure is especially deadly.

Smoking contributes to the development and severity of asbestos-related diseases in three ways:

  • Smoking impairs your lungs’ natural self-cleaning ability. The airways in your lungs are lined with tiny brush-like structures called cilia, which sweep dust particles out to keep your lungs clear. Smoking damages cilia, making it harder for them to expel pollutants, including asbestos fibers.
  • Smoking increases inflammation and scarring in your lungs. Tobacco smoke and asbestos fibers can cause the buildup of scar tissue in your lungs. In addition, smoking changes how your immune system reacts to asbestos, causing your lungs to develop even more scar tissue than they would otherwise. This can accelerate the onset of asbestosis.
  • Smoking reduces your lungs’ ability to absorb oxygen. Tobacco smoke gradually destroys many of your lungs’ alveoli — the tiny air sacs that transfer oxygen into the bloodstream. This adds to the breathing difficulty caused by any scar or cancer tissue that has formed around lodged asbestos fibers.

Smoking, Asbestos and Lung Cancer

Lung cancer is the leading cause of cancer death in the U.S., killing more than 150,000 Americans each year. It is the second most common cancer diagnosis in the nation after breast cancer.

According to the Centers for Disease Control, smoking is the cause of 80 to 90 percent of lung cancer cases, while asbestos exposure is cited as the primary cause in only about 4 percent of cases.

However, reality is more complex than these statistics. When a patient has a history of tobacco use and asbestos exposure, it is difficult to determine the primary cause of their cancer.

However, the combination of smoking and asbestos exposure certainly creates a severe risk of developing lung cancer.

A 2020 study published in Environmental Research and Public Health confirmed that any amount of asbestos exposure contributes to the causation of lung cancer, even in heavy smokers.

A 2013 study involving more than 50,000 medical records revealed how occupational asbestos exposure and smoking have a synergistic effect on lung cancer death rates.

Occupational asbestos exposure on its own was associated with a lung cancer death rate five times higher than average, but when asbestos exposure was combined with smoking, the death rate was 28 times higher than average. The study also showed quitting smoking gradually reduces a person’s risk of lung cancer, whereas the hazard caused by asbestos exposure is irreversible.

Death rate when asbestos exposure was combined with smoking

The death rate was 28 times higher than average when asbestos exposure was combined with smoking
Source: American Thoracic Society

Smoking and Mesothelioma

Although smoking increases your risk of asbestos-related lung cancer, it does not appear to increase your risk of mesothelioma, which is the cancer most commonly associated with asbestos exposure.

However, smoking does worsen the symptoms of mesothelioma and reduce your body’s overall ability to heal, and doctors advise all patients with cancer or respiratory illnesses to avoid tobacco smoke.

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Asbestos in Cigarettes

In the U.S., one tobacco product is known to have been manufactured with asbestos as an ingredient: Kent Micronite filtered cigarettes. From 1952 to 1956, H&V Specialties manufactured cigarette filters for the Lorillard Tobacco Company using a type of asbestos called crocidolite.

Lorillard marketed Kent Micronites as the safest cigarettes ever invented, claiming the design was inspired by high-tech industrial filtration technology. Unfortunately, crocidolite is now widely considered the most toxic form of asbestos.

Although crocidolite was used in certain specialized filters, the crimped crepe paper of the Micronite cigarette filter did not prevent consumers from inhaling microscopic crocidolite fibers when they smoked Kent cigarettes. One study found a smoker could inhale “an average of 170,000 crocidolite airborne structures” from only two puffs on a Kent Micronite.

In general, cigarette filters do not make cigarettes significantly safer. The filters typically only trap the largest tar particles, allowing most of the toxic substances in cigarettes to pass through. The main purpose of a cigarette filter is to make the smoke inhaled seem less harsh and let consumers feel the cigarette is safe. This combination likely facilitated more frequent smoking and the development of addiction to cigarettes.

The Kent Micronite filter actually made smoking more dangerous by adding asbestos to the list of cancer-causing substances smokers were exposed to.

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