# Cannabis Use and Adverse Childhood Experiences Among Cancer Survivors

## TL;DR

Cancer survivors with more adverse childhood experiences are more likely to use cannabis, suggesting a need for trauma-informed care.

## Contribution

This study identifies a novel association between adverse childhood experiences and cannabis use among cancer survivors in the U.S.

## Key findings

- Cancer survivors with 2–3 ACEs had 2.56 times higher odds of cannabis use compared to those with 0 ACEs.
- Cancer survivors with ≥ 4 ACEs had 4.10 times higher odds of cannabis use compared to those with 0 ACEs.
- Cannabis use was more common among younger adults, Hispanics, never-married individuals, smokers, and those with fair/poor health.

## Abstract

To examine the association between adverse childhood events (ACEs) and cannabis use among adult cancer survivors in the United States.

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.

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.

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.