By Jonny Lupsha, News Writer

The Beverly Hills City Council has voted to ban most tobacco sales by 2021, NBC News reported June 5. For over 50 years, tobacco use has been linked to lung cancer.

According to the NBC News article, the only exemptions from Beverly Hills’s tobacco sales ban will be hotels and just three cigar lounges located throughout the city. The connection between tobacco use—especially secondhand smoke—and cancer has been a growing concern around the world for decades. From a national perspective, cancer costs Americans hundreds of billions of dollars a year; lung cancer specifically has been on the rise for nearly a century.

Trends in Lung Cancer Mortality and Smoking

Lung cancer deaths in males have been on the rise since 1930. But why? “Smoking, of course, is related to lung cancer,” said Dr. David Sadava, Adjunct Professor of Cancer Cell Biology at the City of Hope Medical Center. “Many men in America started smoking in World War I.” Dr. Sadava said that during World War I, tobacco companies freely supplied soldiers with cigarettes—and that many of them got hooked while in the service. “This was in the 19-teens and early 1920s, and you can see that if you get hooked in the 19-teens, 20 years later there’s going to be an increase in cancer,” he said.

However, in women, the spike in lung cancer mortality came in the 1950s and ’60s. According to Dr. Sadava, the tobacco companies offered women working in factories during World War II all the free cigarettes they wanted. “The women working in factories got all the cigarettes they could smoke, they became hooked on cigarettes and became smokers after World War II,” he said. “Sure enough, 20 years later in the 1950s and ’60s, there is an increase in cancer.”

Data shows that lung cancer is the second most common kind of cancer in both males and females. The leading cancers are prostate in males and breast in females.

Economic Costs of Cancer

The medical costs for different kinds of cancer vary greatly. Dr. Sadava attributed these variances to two factors. First, he said, it may owe in part to when the cancer is diagnosed. The further along the cancer has progressed, the more treatment a patient needs. “For example, lung cancer is diagnosed late when patients are sicker so they need more care,” he said. Second, different kinds of cancer require different kind of treatment regardless of progression. The above statistics published by the National Cancer Institute list an annual national expense of $19.7 billion in the United States just to treat breast cancer in 2018. In terms of the other most common forms of cancer, Americans spent $15.3 billion in 2018 to treat prostate cancer and nearly $14.2 billion on treating lung cancer.

A study published by the National Institutes of Health also found that the stage at which breast cancer is diagnosed determines the significant incremental costs during the first year of treatment. Each progressive stage, Stage 0, Stage I, Stage II, Stage III, or Stage IV, was found to cost more to treat than earlier stages, keeping with Dr. Sadava’s first hypothesis about treatment costs.

Overall, treating cancer is a major financial burden in America. But aside from the out-of-pocket financial costs that patients might face, there is also a considerable physical toll that patients experience from treatments such as chemotherapy, radiation, and surgery.

Dr. David Sadava contributed to this article. Dr. Sadava is Adjunct Professor of Cancer Cell Biology at the City of Hope Medical Center in Duarte, CA, and the Pritzker Family Foundation Professor of Biology, Emeritus, at The Claremont Colleges. He earned a Ph.D. in Biology from the University of California, San Diego.