Cancer survivors with poorer mental health were more likely to use cannabis

To examine whether measures of health status and quality of life (QoL) were associated with cannabis use after cancer diagnosis. Individuals who received care at an NCI-designated cancer center from 2018 to 2019 (n = 5,901) were invited to complete an online survey in 2022, of which 954 responded. We included 652 respondents in this study, which were weighted to represent the cancer center patient population [58.6% non-Hispanic White; 58.5% female; 51.8% ≥ 65 years]. We examined three self-rated exposures including physical health, mental health, and QoL each assessed using a single survey item with response options ranging from poor to excellent and dichotomized as 'Average or Below Average' or 'Above Average' (referent). Post-diagnosis cannabis use was self-reported as 'Yes' or 'No' (referent). Survey-weighted logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs), and to explore whether these associations differed by cancer stage, treatment status, or pre-diagnosis cannabis use. Most reported above average status for mental health (67.2%) and QoL (64.2%), and almost half (47.1%) reported above average physical health. Odds of post-diagnosis cannabis use were significantly higher among survivors with average or below average mental health (OR = 1.88; 95%CI = 1.13-3.11). Associations were positive but not statistically significant for physical health (OR = 1.38; 95%CI = 0.85-2.24) and QoL (OR = 1.24; 95%CI = 0.75-2.05). These associations did not significantly differ by cancer stage, treatment status, or pre-diagnosis cannabis use. Cancer survivors reporting average or below average health status or QoL had higher odds of cannabis use.