Ellen J. Hahn, Nicholas B. Conley, William C. Haneberg, Elizabeth Anderson-Hoagland, Clay Hardwick

What if every healthcare professional advised their patients who smoke to test their homes for radon? What if every radon professional urged homeowners with high radon to adopt a smoke-free home? The purpose of this paper is to describe a novel pilot project to increase capacity for coordinated lung cancer prevention by integrating public health systems for radon and tobacco risk reduction.

The purpose of the pilot project is to brainstorm ways to build capacity, promote collaboration, and break down traditional silos. The goals are to: (1) create a novel partnership within and between programs at the state health department and the university; and (2) actively engage radon professionals and tobacco control specialists in a conversation to develop novel ways of combining the radon and tobacco smoke risk reduction message. The project team is comprised of experts in the fields of radon, tobacco control, and geology from the Kentucky Department for Public Health’s radon and tobacco control programs, faculty and staff from the Kentucky Geological Survey, and faculty and staff from the University of Kentucky’s College of Nursing BREATHE team. The team submitted abstracts to present at two state conferences (i.e., Kentucky Rural Health Association Conference; Kentucky Environmental Health Association). We shared an interactive, hour-long ‘road show’ presentation with public health professionals to provide basic radon and tobacco smoke education, and summarized existing programs, projects, and activities led by each organization. We highlighted one example of a successful collaboration between BREATHE’s Radon Policy Division and the Kentucky Geological Survey to create new geologic county-level maps to emphasize synergistic risk, personalize radon risk potential, and prompt radon testing (see https://www.uky.edu/breathe/radon/radon-data-county).

The ‘road show’ concluded with an audience conversation to generate ideas for combining the message. First, they recommended launching an ad campaign on the combined risk of radon and tobacco smoke exposure. One low-cost strategy could be to include the free tobacco quit line (800-QUIT-NOW) on National Radon Action Month advertisements and social media posts. Second, audience members suggested collaborating with schools to reach parents and youth. They proposed that radon and tobacco smoke exposure be added to the school health screening questions. The recommendation to partner with schools is supported by the BREATHE team’s research revealing that the presence of children in the home did not prompt action to prevent lung cancer.1 Lastly, audience members advised us to actively and deliberately connect existing health and wellness coalitions with radon and tobacco resources for radon testing and remediation (e.g., mitigation and adoption of smoke-free homes).

The pilot project has yielded several preliminary outcomes. First, the state tobacco control program invited the state radon coordinator to present at a monthly Tobacco Control Webinar, attended by 65 tobacco control specialists. Second, the BREATHE Radon Policy Program manager was invited to present information about the combined risk of radon and tobacco smoke at a statewide radon mitigation training. Lastly, the state tobacco prevention and cessation manager has agreed to join the BREATHE Radon Bi-weekly meetings to promote coordination. 

In conclusion, public health systems need to promote collaboration and integration between radon and tobacco control programs. We recommend that radon measurement and mitigation professionals provide quit materials during radon testing and mitigation and that all tobacco cessation programs provide free radon test kits. All radon measurement and mitigation training needs to include information about tobacco cessation and smoke-free homes resources. All tobacco control conferences need to include radon prevention strategies. If we work together, or at least share radon resources with the tobacco control community, this will start the conversation about combined lung cancer risk. Finding novel ways to integrate radon and tobacco exposure messages will improve radon testing and mitigation rates.

For more information, go to www.breathe.uky.edu. Follow BREATHE on twitter @UkyRadon


  1. Huntington-Moskos L, Rayens MK, Wiggins A, Hahn EJ. Radon, Secondhand Smoke, and Children in the Home: Creating a Teachable Moment for Lung Cancer Prevention. Public health nursing (Boston, Mass). 2016;33(6):529-538.