Clean air, cancer prevention, and health – insights from Kuwait

Drawing together findings from multiple systematic reviews and meta‑analyses, UICC’s recent evidence report Clean air in cancer control shows that long‑term exposure to polluted air increases the risk of developing cancer and the risk of dying from cancer, not only for lung cancer but across a range of cancer types.

The report also highlights that these risks are borne disproportionately by vulnerable populations, including children and women, compounding existing health inequities. Communities living near major roads, industrial sites, or poorly regulated waste facilities often face higher and more sustained exposure.

Furthermore, when air quality is poor, health services are required to respond not only to higher rates of illness, but also to patients whose underlying conditions are aggravated by polluted environments, stretching already limited resources.

Exposure to pollutants is shaped by wider commercial and social determinants of health, largely shaped by policy choices: how tobacco and vaping products are marketed and sold, where smoking is permitted, how transport systems are designed, how waste is regulated, across transport, energy, urban planning, waste management, and environmental regulation. How all influence exposure in shared spaces in ways that go well beyond individual choice. Air pollution in particular air pollution is a risk factor that individuals have limited to no ability to avoid.

Policies and standards alone are not sufficient, however, if they are poorly enforced or disconnected from health planning. Clean air measures that reduce exposure can ease pressure on health systems by preventing disease, improving outcomes for people living with cancer, and protecting investments in treatment and care.

Setting the example in Kuwait: Fadia Survive and Thrive

Fadia Survive and Thrive, an international cancer patient advocacy organisation based in Kuwait and a UICC member, has recently extended its long‑standing focus on evidence‑based patient advocacy of cancer risks, notably tobacco, to address air pollution.

“From the beginning, our work has been about finding reliable, evidence‑based information and making it accessible,” said Rania Azmi, Co‑Founder of Fadia Survive and Thrive. “Our motivation has always been to understand what really affects cancer risk and outcomes, and to close the gaps between evidence, public awareness, and policy.”

The organisation’s work initially centred on tobacco and lifestyle‑related risks, but over time expanded to include air quality. Some sources of air pollution in Kuwait are shaped by natural conditions, such as regional dust storms, and not within the control of individuals or even governments. “Other pollutants, however, notably smoking and vaping in public spaces, and vehicle emissions, are shaped by policy choices, enforcement, and public awareness,” Azmi explains.

“These are areas where government policy can reduce harm, particularly for communities with fewer options to avoid pollution,” said Rania Azmi. “My main concern is where action is possible but not happening, particularly around smoking, vaping, and other everyday sources of pollution,” she said. “These are areas where sensitising people on the harms of pollutants and working with government officials on enforcement could make a real difference.”

Weak or unevenly enforced regulation further reinforces the inequities that arise from the fact that exposure to air pollution and its health impacts is not distributed evenly.  “Nevertheless, we should not forget that polluted air does not remain neatly confined,” Azmi emphasised. “It moves across neighbourhoods, and its affects ultimately everyone.”

Similarly to how they engaged on tobacco control, Fadia Survive and Thrive’s approach to advocacy combines policy engagement with direct communication to people living with cancer, their families and caregivers, and the wider public.

“Our work began by addressing misinformation and misconceptions around cancer risks and prevention,” Azmi explains. “Early initiatives focused on translating scientific evidence into practical guidance, engaging directly with patients and caregivers, and challenging widely held assumptions.” Over time, this approach expanded beyond individual behaviours to include environmental exposures, as evidence highlighted the role of air quality alongside smoking and other established risk factors.

Fadia Survive and Thrive has concentrated on advocating for stronger regulation of smoking and vaping in shared spaces, drawing attention to vehicle emissions and waste practices, and highlighting gaps between existing rules and their implementation. 

In Kuwait, some of the foundations for clean air policy are already in place. Rania Azmi pointed to the role of the Public Authority for Environment, which monitors air quality indicators such as particulate matter and weather conditions and makes this information publicly available. She also noted that industrial emissions, particularly in the oil sector, are subject to international standards and regulatory oversight.

“We have measures in place, but enforcement and public awareness remain insufficient,” Azmi said. “Vaping and smoking awareness, for instance, is a real missed opportunity. Many people do not realize that growing evidence shows both release fine particles and volatile compounds that can affect vulnerable groups. Both practices should be avoided, even in public or open spaces, particularly when children or cancer patients are present, as they may be more susceptible to airborne pollutants.”

The organisation makes use of media and public platforms to ground discussion of air pollution in evidence, counter alarmist or misleading narratives, and frame clean air as a cancer prevention issue rather than a distant environmental concern. It calls for integrating air pollution alongside tobacco control within national cancer strategies – not as a separate environmental concern, but as a determinant of cancer risk, equity, and effective care delivery.

Turning evidence into policy action

To support its members and address how evidence is translated into action, UICC organised earlier this year a series of workshops to present its findings and mobilise member engagement in calling for clean air policies. Framing clean air as a cancer issue – alongside tobacco and other established risks – is core to the advocacy approach, helping to situate environmental policy within health and equity debates.

UICC will be publishing later in the year an advocacy agenda on cancer and clean air. This policy paper, which was presented at the workshops, sets out priorities for reducing population‑level exposure and embedding clean air within cancer prevention and control efforts.

The agenda notably calls for cancer organisations to engage on four core fronts: strengthening access to and use of air quality data; improving understanding of air pollution as a cancer risk factor and determinant of outcomes; integrating clean air measures into national cancer control plans and noncommunicable disease strategies; and partnering with existing clean air coalitions rather than working in isolation.

By providing a shared framework for policy engagement, UICC’s advocacy agenda is designed to enable cancer organisations to contribute to clean air debates in ways that are grounded in health outcomes and aligned with broader cancer control goals.

Learn more about the impact of air pollution on cancer