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PATTERNS OF CANNABIS USE AMONG CANCER SURVIVORS: INSIGHTS FROM THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM
Zayed Rashid
*, Mujtaba Khalil, Abdullah Altaf, Shahzaib Zindani, Azza Sarfraz, Timothy M. Pawlik
Surgery, The Ohio State Wexner Medical Center, Columbus, OH
Introduction: Cancer survivors represent a growing population facing unique challenges, including managing symptoms like chronic pain and anxiety. Cannabis has been legalized across multiple states for its potential medical benefits; however, its use among cancer survivors remains understudied. Therefore, we sought to define factors associated with cannabis use among cancer survivors.
Methods: Cancer survivors were identified from the Behavioral Risk Factor Surveillance System. Data across 23 states that completed the optional opioid module in 2021 were included. Cannabis use was divided into low (i.e., 0-19 days) and high frequency (i.e., 20-30 days) of use. Weighted multivariable regression models were used to study the association of factors associated with cannabis use among cancer survivors.
Results: Among 18,550 cancer survivors, most were female (n=11,029, 51.7%), self-identified as White (n=16,249, 81.2%) and were older than 65 years (n=12,559, 57.8%) (
Figure). Most patients reported housing stability (n=15,096, 82.9%), as well as good mental (n=15,949, 85.4%) and physical health (n=14,171, 77.5%). Overall, 13.4% (n=2,070) of the individuals reported smoking cigarettes, 2.8% (n=418) used e-cigarettes, and 2.0% (n=307) used smokeless tobacco; 7.0% (n=1,164) of individuals reported heavy alcohol intake. Overall, 8.8% (n=1,278) of individuals used cannabis and most used it for non-medical reasons (n=667, 52.7%); there was equal distribution based on frequency of use (low frequency: n=626, 50.1% vs. high frequency: n=652, 49.9%). On multivariable analyses, males (ref. females: OR 1.54, 95%CI 1.34-1.77) and Black individuals (ref. White: OR 1.35, 95%CI 1.01-1.81) with younger age (18 to 44 years)(ref. aged ? 65: OR 4.00, 95%CI 3.22-4.96) were at higher odds of cannabis use (all p<0.05). Similarly, individuals who were active smokers (ref. nonsmokers: OR 3.89, 95%CI 3.21-4.72), used e-cigarettes (ref. non-users: OR 2.82, 95%CI 2.17-3.66), and had high alcohol intake (ref.: low intake: OR 2.39, 95%CI 1.99-2.87) had higher odds of cannabis use (all p<0.05). Of note, males (ref. females: OR 2.57, 1.50-4.41) and individuals with heavy alcohol intake (ref. low intake: OR 2.41, 95%CI 1.28-4.54) had higher odds of cannabis use for non-medical reasons (both p<0.05). In contrast, individuals with better baseline physical health had lower odds of non-medical cannabis use (ref. poor physical health: OR 0.41, 0.21-0.82).
Conclusion: Roughly 1 in 12 cancer survivors used cannabis. The pattern of use varied based on clinicodemographic factors and concurrent substance use such as tobacco or alcohol.
Cannabis use in states administering Behavioral Risk Factor Surveillance System cannabis use module.
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