Abstract Introduction. This study examines how three specific childhood adversities—family mental illness, physical abuse, and sexual abuse—relate to adult cannabis use among cancer survivors, with attention to racial differences. While prior research has explored these links in the general population, limited work has focused on how such early-life experiences impact health behaviors in cancer survivor populations. Methods. Using 2020 BRFSS data, we analyzed 7,896 adult cancer survivors to assess associations between three ACEs—family mental illness, physical abuse, and sexual abuse—and cannabis use. All variables were binary. Weighted multivariable logistic regression was used, adjusting for sociodemographic factors, to evaluate these relationships within a racially diverse survivor population. Results. In this sample of cancer survivors, 15.5%, 23.6%, and 6.3% reported experiencing the three ACEs: mental illness in family members, physical abuse, and sexual abuse, respectively. Regarding cannabis use, 6.1% used cannabis. In terms of racial differences, the adjusted models indicated that Hispanic cancer survivors had higher odds of cannabis use when they experienced mental illness (aOR: 2.53, 95% CI: 1.08–3.75), experiencing physical harm (aOR: 2.52, 95% CI: 1.16–5.48), and being subjected to sexual abuse (aOR: 2.87, 95% CI: 1.30–6.34) compared to Whites, but lower odds of smoking (aOR: 0.47, 95% CI: 0.28–0.80) compared to Whites. There were no statistically significant differences between Whites and Blacks. Conclusion. This study reveals a strong connection between early-life adversity and cannabis use among cancer survivors. Specifically, family mental illness and physical abuse were significant predictors among Hispanics. These findings support the integration of trauma-informed care into survivorship programs. Addressing childhood adversity may improve behavioral health outcomes and guide targeted prevention strategies for reducing substance use and promoting long-term well-being in this vulnerable population. Citation Format: Oluwole A. Babatunde, Nosayaba Osazuwa-Peters, Eric Adjei Boakye. The impact of childhood family mental illness and abuse on adult cannabis use: Exploring racial differences among cancer survivors abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A119.
Babatunde et al. (Thu,) studied this question.