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Published on: August 1, 2025
Cannabis Use and Adverse Childhood Experiences Among Cancer Survivors
May Z Gao1, Oluwole A Babatunde2, Melanie S Jefferson3
1Duke University School of Medicine, Durham, North Carolina, USA.
Objective:
To examine the association between adverse childhood events (ACEs) and cannabis use among adult cancer survivors in the United States.
Methods:
We conducted a cross-sectional study of cancer survivors ≥ 18 years old using 2020 Behavioral Risk Factor Surveillance System data. ACEs were categorized as 0, 1, 2-3, and ≥ 4. Weighted multivariable logistic regression estimated the odds of cannabis use by ACE category.
Results:
Among 7896 cancer survivors, cannabis use prevalence was 6.0%. ACE distribution was 44.1% (0), 22.7% (1), 20.2% (2-3), and 13.0% (≥ 4). Cannabis use was more common among younger adults, Hispanics, never-married individuals, smokers, and those reporting fair/poor health. Compared to those with 0 ACEs, cancer survivors with 2-3 ACEs (aOR: 2.56, 95% CI: 1.57-4.27) and ≥ 4 ACEs (aOR: 4.10, 95% CI: 2.54-6.64) had significantly higher odds of cannabis use.
Conclusions:
Cancer survivors with a higher number of ACEs reported increased odds of cannabis use. These findings support further study of ACEs and substance use in cancer survivors and may inform trauma-informed survivorship care.
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