Cancer survivors who experienced four or more adverse childhood events had quadruple the odds of cannabis use compared to those with no childhood adversity.
Oncologists, survivorship care providers, and anyone interested in how childhood adversity shapes adult health behaviors in cancer populations.
What the researchers found
Among nearly 8,000 cancer survivors, those with four or more adverse childhood experiences (ACEs) had 4.1 times greater odds of cannabis use compared to those with zero ACEs, with a clear dose-response pattern.
Why it matters
Childhood trauma appears to be a strong predictor of cannabis use in cancer survivors, suggesting that substance use screening in oncology settings should account for early life adversity.
The numbers in context
6.0% overall cannabis use prevalence among cancer survivors. 44.1% reported zero ACEs. Adjusted odds ratios: 2-3 ACEs = 2.56 (95% CI: 1.57-4.27); 4+ ACEs = 4.10 (95% CI: 2.54-6.64).
How the study worked
Cross-sectional analysis of 7,896 cancer survivors from the 2020 Behavioral Risk Factor Surveillance System. ACEs were categorized into four groups (0, 1, 2-3, 4+). Weighted multivariable logistic regression controlled for demographics, smoking, and health status.
What this study cannot tell us
Cross-sectional design cannot establish causation. Self-reported data on both ACEs and cannabis use introduces recall bias. The BRFSS does not distinguish between medical and recreational cannabis use.
How to read the evidence
Large nationally representative sample with appropriate statistical controls, but cross-sectional design limits causal inference.
When this study was published
2025 publication using 2020 survey data.
The bigger picture
This study adds to growing evidence that substance use patterns in cancer survivors are shaped by early life experiences, not just their cancer diagnosis.
Questions still open
- Does cannabis use in trauma-exposed cancer survivors reflect self-medication for psychological distress?
- Would trauma-informed interventions in oncology reduce substance use or improve outcomes?
Common questions
Why would childhood trauma affect cannabis use decades later?
Is cannabis use harmful for cancer survivors?
Read the original research
Cannabis Use and Adverse Childhood Experiences Among Cancer Survivors.
Cancer medicine, 14(22), e71400
Citation
Gao, May Z; Babatunde, Oluwole A; Jefferson, Melanie S; Adams, Swann A; Hughes Halbert, Chanita; Osazuwa-Peters, Nosayaba; Adjei Boakye, Eric. (2025). Cannabis Use and Adverse Childhood Experiences Among Cancer Survivors.. Cancer medicine, 14(22), e71400. https://doi.org/10.1002/cam4.71400
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