Patterns of Cannabis Use Among Cancer Survivors: Insights From the Behavioral Risk Factor Surveillance System.

Abstract

Cannabis has been legalized across multiple states over the past decade; however, its use among cancer survivors remains understudied. Therefore, we sought to define factors associated with cannabis use among cancer survivors. This study used the Behavioral Risk Factor Surveillance System to identify cancer survivors across 23 states that completed the optional cannabis module in 2021. Weighted multivariable regression models were used to study the factors associated with cannabis use among cancer survivors. Among 6,168,964 cancer survivors, most were female (n = 3,621,182, 58.7%), White (n = 5,009,199, 81.2%), and older than 65 years (n = 3,565,661, 57.8%); 8.8% (n = 542,868) of individuals used cannabis and most used it for nonmedical reasons (n = 3,251,044, 52.7%); roughly an equal proportion of patients reported low (n = 3,090,651, 50.1%) versus high (n = 3,078,313, 49.9%) frequency use. Male (ref. female: odds ratio [OR], 1.54 [95% CI, 1.34 to 1.77]) and Black (ref. White: OR, 1.35 [95% CI, 1.01 to 1.81]) individuals and younger individuals (ref. aged ≥65: OR, 4 [95% CI, 3.22 to 4.96]) had higher odds of cannabis use. Male (ref. female: OR, 2.57 [95% CI, 1.50 to 4.41]) and individuals with heavy alcohol intake (ref. low intake: OR, 2.41 [95% CI, 1.28 to 4.54]) had higher odds of cannabis use for nonmedical reasons. State-level legalization of cannabis was associated with an increase in cannabis use over time (4.5% [95% CI, 4.3 to 4.8]; <i>P</i> < .001). 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 among cancer survivors who resided in states that legalized cannabis was higher.