In the commonwealth of Kentucky, the burden of lung cancer remains alarmingly high. According to the American Lung Association, Kentucky is among the states with the highest incidence of new lung cancer cases — 84.8 per 100,000 people — compared with the U.S. average of about 54.6. Also, survival after diagnosis lags: the five-year survival rate in Kentucky is around 23.9%, below the national rate of 28.4%.

Why is Kentucky facing this challenge? Some key contributing factors:

• Adult smoking remains significantly above the national average: 17.4 % in Kentucky vs 12.9% nationwide
• Many cases continue to be diagnosed late, making treatment less effective.
• Other exposures such as radon, mining dust, or occupational hazards play a role, but the dominant risk factor remains tobacco smoke.

Given this context, awareness efforts are critical. While smoking remains the dominant risk, vaping (use of e-cigarettes or electronic nicotine delivery systems) is rapidly entering the conversation—and it’s relevant for our community. While the causal links between vaping and lung cancer are still under investigation, there are several strong reasons why vaping cannot be ignored in lung cancer awareness, especially within Kentucky.

Dual Use & Increased Risk

Vaping is not risk-free. Especially for smokers supplementing with e-cigs (dual use), risk appears higher. Even for non-smokers, early signs of harm are emerging. A study highlighted by Kentucky Health News found that individuals who both smoked conventional cigarettes and used e-cigarettes had four times the lung cancer risk compared to those who only smoked. The doubling (or more) of risk suggests that vaping in addition to smoking broadens exposure to toxins, rather than replacing one risk with a lesser one.

Exposure to Toxic Chemicals

Vaping devices may emit aerosol containing known carcinogens and toxins—formaldehyde, acetaldehyde, acrolein, heavy metals like nickel and chrome—especially when flavors and heating elements are involved. Though long-term data on vaping and cancer in humans is limited, these findings raise serious concerns.

High Prevalence Among Kentucky Youth and Adults

Kentucky has one of the highest rates of e-cigarette use in the nation. A study found the state ranked second in adult daily vaping and about 20% of high school students report e-cigarette use.
High youth uptake means more people exposed earlier in life, increasing the window for potential adverse lung health outcomes over decades.

Since our region has high baseline lung cancer rates, the addition of newer risk behaviors, like vaping, means we must broaden our prevention message—not only focusing on quitting smoking, but also avoiding or stopping vaping, especially when combined with other lung exposures.

Here’s what you can do when it comes to prevention, screening and support:

• If you smoke or have smoked, talk to your doctor about whether you qualify for lung-cancer screening (LDCT). Early detection saves lives.
• If you vape or are considering vaping, please recognize that the long-term lung effects are still being studied—and vaping plus smoking may raise your risk significantly.
• Get your home tested for radon gas—especially if you live in central/eastern Kentucky where geological conditions place you at higher risk.
• Support loved ones in quitting—whether cigarettes or vaping devices. Quitting both is important.
• Stay alert to respiratory symptoms: persistent cough, shortness of breath, unexplained weight loss—especially in those with risk factors. Early evaluation matters.

Lung cancer is preventable, treatable and beatable, especially when we act early and decisively. In Kentucky, where lung cancer remains a major public-health challenge, combining the traditional fight against smoking with attention to newer behaviors like vaping is essential. By elevating awareness, promoting screening, and supporting cessation, Kentucky has the opportunity to reduce future lung cancer burdens.