ASPO Abstracts
Risk and protective factors of tobacco, alcohol, and marijuana use among young adult childhood cancer survivors: a longitudinal study
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2020
Abstract Body:
Purpose The current investigation sought to examine prospective changes in substance use during young
adulthood among a cohort of childhood cancer survivors (CCS).
Methods: Participants included a sample of 127 CCS (57% were Hispanic, 55% female, average age at
diagnosis 12.4 yrs) who participated in the Project Forward pilot study and a subsequent expanded
Project Forward cohort study. Cases were identified from the Los Angeles Cancer Surveillance Program
and were diagnosed with any cancer type (except Hodgkin lymphoma) at two large pediatric medical
centers in Los Angeles County between 2000 and 2007, between the age of 0-18 at diagnosis, and at
least two years from diagnosis. Measures assessing cancer treatment intensity, depressive symptoms,
survivorship clinic attendances, and prior 30-day binge drinking of alcohol, marijuana use, and
cigarette/tobacco use were completed between 2007-2009 at baseline/Time 1 (T1), with follow-up/Time 2
(T2) surveys completed between 2015-2018. Mean age at T2 was 24.9 yrs.
Results: Rates of 30-day use increased over time for binge drinking of alcohol (from 25% to 38%),
marijuana (from 11% to 23%), and cigarette/tobacco (from 7% to 8%). After adjusting for T1 substance
use, depressive symptoms and survivorship clinic attendance (at T1) were not associated with any T2
substance use. T1 Marijuana use and T1 cigarette use were significantly association with T2 Marijuana
and cigarette use, respectively. T1 binge drinking was not associated with T2 binge drinking. Receipt of
more intensive cancer treatment was protective for tobacco use over time, but not associated with the
other substances.
Conclusions: As CCS mature into adulthood, their substance use increases which may compound the risk
for treatment-related late effects. Greater health education efforts among CCS on potential risks
associated with tobacco, alcohol and marijuana use are needed in this at-risk population.
Keywords: Substance use; Young adult