Binge Drinking, Tobacco, and Marijuana Use Among Young Adult Childhood Cancer Survivors: A Longitudinal Study

Abstract

Objectives: Substance use among young adult childhood cancer survivors (YACCSs) has been found to increase during survivorship, resulting in increased risk of developing long-term negative health outcomes. This investigation sought to determine various risk and protective factors of tobacco, alcohol, or marijuana use over time among a sample of YACCSs. Methods: 127 YACCSs (57% Hispanic, 55% female, average age at diagnosis 12.4 years) who were diagnosed with any cancer type (except Hodgkin lymphoma) at two large pediatric medical centers in Los Angeles County between 2000 and 2007 responded to two surveys separated by ∼5 years. Bivariate logistic regression models were used to assess independent clinical and psychosocial Time 1 variables associated with each substance use outcome at Time 2. Time 1 variables significant at p < .10 were included in multivariable logistic regression models for each Time 2 substance use variable. Results: Rates of 30-day use increased over time for binge drinking alcohol (from 25.6% to 37.7%), marijuana (from 10.6% to 22.1%), and cigarette/tobacco (from 8.9% to 12.2%). Of the following Time 1 variables, marijuana use, cigarette use, and binge drinking were associated with Time 2 marijuana, cigarette, and binge drinking, respectively. Of the following clinical factors, receipt of more intensive cancer treatment was associated with decreased tobacco use. All other psychosocial and clinical factors analyzed were not associated with any increase or decrease in substance use. Conclusions: A greater emphasis on early health education efforts regarding the health risks of tobacco, alcohol, and marijuana use is needed in this at-risk population.

Psychological, functional and social outcomes in adolescent and young adult cancer survivors over time: A systematic review of longitudinal studies

“…Of the 1050 articles screened, the full texts of 141 papers were reviewed resulting in 13 reports from 10 studies included in this review (Figure 1). 30 Studies were undertaken between the years 2007–2021 and at baseline represented a total of 17,645 (50.3% female) AYA diagnosed with cancer in Europe ( n = 7) 31–37 and North America ( n = 6) 38–43 . Five studies did not report attrition, providing data only for participants that had contributed data at two or more time points 31,37,40,41,43 .…”

“…Studies ranged in duration from 12 months to up to 13 years, with data collected a mean of 2.7 times, and up to five times in the larger studies (see Supporting Information S2). Seven studies were quantitative longitudinal designs with no comparator group 32,35–39,43 . Four studies were quantitative longitudinal cohort studies with a comparative control group, 33,40–42 and two were qualitative longitudinal studies 31,34 .…”

“…Within the functional health domain, health behaviours (sleep, smoking, alcohol use) were the focus of three studies (7769 baseline participants) 41–43 . Capelli et al.…”

“…Challenges with recruitment, resulting in small sample sizes were reported in several studies 31,33,34,39,43 . High attrition rates and challenges to follow up with participants were also reported 32,38 .…”

“…Among the included reports, it was widely recognised that more longitudinal studies with larger sample sizes were required to understand the impacts and severity on long‐term health and well‐being of AYA cancer survivors 33,34,39–41,43 . The need to actively promote retention was less widely acknowledged 38 …”