JOPHON NCPD (2021 Sept/Oct) - Binge Drinking, Tobacco, and Marijuana Use Among Young Adult Childhood Cancer Survivors-ARTICLE: JOPHON CNE (2021 Sept/Oct) - Binge Drinking, Tobacco, and Marijuana Use Among Young Adult Childhood Cancer Survivors

ARTICLE: JOPHON CNE (2021 Sept/Oct) - Binge Drinking, Tobacco, and Marijuana Use Among Young Adult Childhood Cancer Survivors

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This longitudinal study examined changes in binge drinking, tobacco, and marijuana use—and their predictors—among young adult survivors of childhood cancer (YACCSs). Participants were 127 survivors (57% Hispanic, 55% female) diagnosed in Los Angeles County pediatric centers (2000–2007) and surveyed twice about 5 years apart (Time 1: 2007–2009; Time 2: 2015–2018). Past-30-day substance use was assessed for cigarettes, marijuana, and binge drinking (≥5 drinks on one occasion). Psychosocial factors (depressive symptoms, stress, quality of life, post-traumatic growth, religious attendance, spirituality) and clinical factors (treatment intensity, follow-up care, survivorship clinic attendance, health-care discussions, SES) measured at Time 1 were tested as predictors of Time 2 use using bivariate and multivariable logistic regression (controlling for baseline use and time between surveys).<br /><br />Substance use increased over time: binge drinking rose from 25.6% to 37.7% (significant), marijuana from 10.6% to ~22% (significant), and cigarette use from 8.9% to 12.2% (not significant). The strongest and most consistent predictor of Time 2 use was prior use of the same substance at Time 1 (e.g., baseline marijuana use predicted later marijuana use; baseline smoking predicted later smoking). Treatment intensity was the only clinical factor associated with reduced substance use: more intensive cancer treatment predicted lower odds of tobacco use at follow-up. For binge drinking, male sex and prior binge drinking predicted Time 2 binge drinking. There was substantial overlap between marijuana use and binge drinking, complicating modeling of binge drinking when marijuana was included.<br /><br />Overall, most psychosocial and care-related variables (including follow-up care and survivorship clinic attendance) were not protective. The authors conclude that YACCSs need earlier, stronger health education and prevention/cessation efforts addressing tobacco, alcohol, and marijuana due to increasing use and potential to worsen treatment-related late effects.

Keywords

young adult childhood cancer survivors

longitudinal study

binge drinking

tobacco use

marijuana use

predictors of substance use

baseline substance use

treatment intensity

psychosocial factors

logistic regression