Occupational exposures were the first recognized to be associated with the development of lung carcinoma. These include radon, arsenic, chromium among other work place chemicals. Despite this, it is believed that smoking is the largest single contributor to the induction of lung cancer. Smoking now accounts for 80-90% of all lung cancer cases, but only 20-30% of smokers will develop lung cancer. Several retrospective studies have found an association between the development of lung cancer and the quantity and duration of smoking. Most carcinogens tend to have a synergistic effect when combined with cigarette smoke. Passive or second hand smoke is considered to account for 25% of nonsmoker related lung carcinoma increasing the risk by 35-53%.

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