Smoking is the biggest risk factor for lung cancer -- and 90 percent of all lung cancer cases are related to smoking. But family history is a risk factor too and can nearly double the risk of developing the deadly disease.

A study published in the October issue of Chest found by studying a population of Japanese adults that people with a first-degree relative -- mother, father, or sibling -- who had lung cancer had a 95 percent higher risk of contracting the disease. Those who smoked had the greatest risk, but those who did not smoke were still at risk. And women were more at risk than men. The type of lung cancer most associated with family history is squamous cell carcinoma.

The results of this study do not yet translate into recommended guidelines for screening. But those with a family history of lung cancer should make their physicians aware of their history. And perhaps one day people with family history will be identified as high-risk for lung cancer and will be included in further studies. In the meantime, these individuals should avoid all contact with all inhaled and second-hand smoke and should protect their children from all forms of tobacco smoke.

The U.S. Centers for Disease Control and Prevention estimates that more than 180,000 cases of lung cancer are diagnosed each year. About 170,000 die from the disease every year. It's the second leading cause of death for men and the third leading cause of death for women.

Lung cancer affects more than 80,000 American women annually. More than 70,000 of these cases are fatal. Thirty thousand more women die from lung cancer than from breast cancer. And lung cancer claims more lives of more women than breast, uterine, and ovarian cancers combined. Yet a new study reveals that American women are uninformed about statistics like these -- and about the threats posed by lung cancer.

A 2006 survey of 500 women provides a snapshot of women's attitudes and beliefs about lung cancer -- and the overwhelming conclusion is that there is a widespread lack of awareness about the nation's top cancer killer. And here's the lowdown:

• Only 41 percent of women know that lung cancer is the leading cancer killer in the United States.
• Only 8 percent of women know that exposure to radon gas is the second leading cause of lung cancer -- 60 percent instead believe that second-hand smoke is the culprit.
• Only 36 percent of women know lung cancer kills more women than breast cancer.
• Only 41 percent of women know that one in 17 women will develop lung cancer sometime in her life.
• Only 4 percent of women know that women typically fare better than men following lung cancer treatment.
• And 25 percent of women mistakingly believe that there is a standard screening test to detect lung cancer in its early stages. Currently, there is not one.

Lung cancer is often believed to be a man's disease. But it is not. It affects tens of thousands of women too. And now I -- as one of the previously uninformed women -- know better.

Michael Fumento is an author, journalist, and attorney specializing in science and health issues. And he has a lot to say about the Surgeon General's recent announcement that the second-hand smoke debate is over -- that second-hand smoke does in fact kill. Fumento believes that the debate is over means if you have your doubts, then keep them to yourself -- that the topic is not up for discussion any longer. But Fumento states that we should definitely have doubts -- about the effects of second-hand smoke and about what the Surgeon General has to say about it.