A31-04 Associations of Frequency of Cannabis Use With Receipt of Lung Cancer Screening and Immunizations

Abstract Rationale Cannabis use is increasingly common in the U.S., and prior studies have suggested a link between cannabis and elevated all-cause mortality. The relationship between cannabis use and preventive health interventions that may reduce mortality is unclear. There is some data to suggest that cannabis use is associated with acute reductions in motivation which may influence receipt of preventive services. We examined the frequency of cannabis use and adherence to guideline-recommended screening and vaccination. Methods We analyzed 2022 Behavioral Risk Factor Surveillance System (BRFSS) data, which included LCS in the core national telephone survey. Exposure, assessed among respondents from states fielding the cannabis module, was days of cannabis use in the past 30 days, modeled as continuous dose-response (per 30 days). For example, a respondent who used cannabis daily over the prior 30 days would be coded as having an exposure of 30/30=1; a respondent who used cannabis 15 of the prior 30 days would be coded as having an exposure of 15/30 = 0.5. Outcomes, among respondents eligible under national recommendations, were receipt of LCS, influenza vaccination, or pneumococcal vaccination. Survey-weighted logistic regression models were used to calculate adjusted odds ratios (aOR) for receipt of each intervention adjusted for race/ethnicity, education, income, marital status, insurance, and employment, accounting for BRFSS complex design. Results The analytic sample included n = 93,735 adults; n = 11,525 reported cannabis use within the past 30 days. Respondents were 48.3% (95% CI 47.7-48.9%) women, 33.1% (95% CI 32.5-33.7%) non-Hispanic White, and had a median age of 50 years (95% CI 50-51). In dose-response models, daily cannabis use was linked to lower odds of respiratory preventive care compared to no cannabis use: LCS 0.52 0.37-0.73, influenza vaccination 0.56 0.50-0.63, and pneumococcal vaccination 0.72 0.61-0.86 per 30 days. Conclusions Cannabis use was associated with lower adherence to pulmonary preventive care, with dose-response declines across LCS, influenza vaccination, and pneumococcal vaccination. While causality cannot be inferred from cross-sectional data, these findings suggest that more frequent cannabis use may be tied to lower use of preventive health interventions that are core components of comprehensive pulmonary care. If corroborated, this association may contribute to observed links between cannabis use and higher mortality. Longitudinal studies should clarify mechanisms such as access barriers, risk perception, or competing health priorities. Findings highlight opportunities to integrate substance-use assessment into pulmonary screening and vaccination outreach. This abstract is funded by: This work was supported in part by Career Development Award Number CX002713 from the United States (U.S.) Department of Veterans Affairs Clinical Science Research and Development Service (Dr. Rustagi). Dr. Rustagi also received support from the National Institute on Aging (1R03AG082924), VA’s Lung Precision Oncology Program, and VA’s VISN21 Early Career Award Program. The study sponsors had no role in the study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the manuscript for publication. The opinions expressed herein are those of the authors and not their employers, the U.S. Department of Veterans Affairs, the U.S. government, or the study sponsors.