Abstract B015: Disparities in cancer risk behaviors, cannabis use and adverse childhood experiences among cancer survivors

Abstract Introduction. Adults who report Adverse Childhood Experiences (ACEs) are more likely to engage in health-risk behaviors. While previous research has explored the associations between ACEs and health-risk behaviors in the general population, studies focusing on cancer survivors are lacking. We examined the association between cannabis use, alcohol consumption, and smoking by race and ACEs among cancer survivors. Methods. Using cross-sectional data from the 2020 Behavioral Risk Factor Surveillance System, we analyzed 7,896 cancer survivors aged ≥18. We categorized the main exposure, ACEs, based on severity into four categories: zero, one, two to three, and ≥four, derived from questions assessing exposure to eight types of ACEs before the age of 18. The outcome measures were cannabis use (yes or no) and cancer risk behaviors: smoking status (current/former smoker or never smoker), binge alcohol use (yes or no). Binge drinking was defined as males consuming five or more drinks on one occasion and females consuming four or more drinks on one occasion. Weighted multivariable logistic regression models examined association between ACE and the outcomes; cannabis use, binge alcohol use and smoking adjusting for sociodemographic factors. Results. In this sample of cancer survivors, 44.1%, 22.7%, 20.2%, and 13.0% reported having experienced zero, one, two to three, and ≥four ACEs, respectively. Personal history of cannabis use was reported by 6.0% of respondents, current/former smokers by 43.4%, and binge alcohol use by 6.2%. In the adjusted models, cancer survivors with one ACE (aOR: 1.55, 95% CI: 0.92–2.60), two to three ACEs (aOR: 2.56, 95% CI: 1.57–4.27), or ≥four ACEs (aOR: 4.10, 95% CI: 2.54–6.64) had higher odds of cannabis use compared to those with zero ACEs. Similarly, cancer survivors with one ACE (aOR: 1.53, 95% CI: 0.99–2.39), two to three ACEs (aOR: 2.18, 95% CI: 1.36–3.48), or ≥four ACEs (aOR: 2.08, 95% CI: 1.25–3.48) had higher odds of binge drinking compared to those with zero ACEs. Finally, cancer survivors with one ACE (aOR: 1.40, 95% CI: 1.12–1.74), two to three ACEs (aOR: 1.94, 95% CI: 1.54–2.44), or ≥four ACEs (aOR: 3.06, 95% CI: 2.29–4.08) had higher odds being current/former smoker compared to those with zero ACEs. In terms of racial differences, the adjusted models indicated that Hispanic cancer survivors had higher odds of cannabis use (aOR: 2.49, 95% CI: 1.13–5.48) compared to Whites, but lower odds of smoking (aOR: 0.47, 95% CI: 0.28–0.80) compared to Whites. Conclusion. ACEs are strong predictors of adult cannabis use and cancer risk behaviors such as binge drinking and smoking. Therefore, individuals with a history of ACEs may represent an important target group for preventive interventions aimed at reducing these risks. Citation Format: Oluwole A. Babatunde, Melanie S. Jefferson, Swann Adams, Chanita Hughes Halbert, Nosayaba Osazuwa-Peters, Eric Adjei Boakye. Disparities in cancer risk behaviors, cannabis use and adverse childhood experiences among cancer survivors abstract. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B015.