Associations among marijuana use, health-related quality of life, exercise, depression and sleep in cancer survivors

Abstract

Aims To assess associations among cannabis use, health-related quality of life, exercise, depression and sleep among a nationally representative sample of US adults living with cancer. Design A cross-sectional correlational study. Methods We used survey data from the 2016-2018 Behavioral Risk Factor Surveillance System. Analyses were considered for sample weights and the complex designs. Logistic regression was performed to assess associations among cannabis use (0, 1-19, vs. 20-30 [frequent] days), health-related quality of life (0-13 vs. >= 14 mentally or physically unhealthy days in the past 30 days; 0-13 vs. >= 14 functionally limited days), exercise, depression, and sleep after accounting for covariates. Reason for cannabis use (medical vs. non-medical) was also assessed. Results Frequent users had significantly more physically unhealthy days (adjusted odds ratio [OR]: 1.79, 95% CI: 1.28-2.51, p < .01) and reported >= 14 mentally unhealthy days (adjusted OR: 2.43, 95% CI: 1.78-3.32, p < .001) and depression (adjusted OR: 2.65, 95% CI: 1.97-3.57, p < .001) compared with non-users. A positive relationship between frequency of cannabis use and depression existed only among non-medical cannabis users. Conclusion Cancer survivors using cannabis frequently (20 days+ in the past month) had poorer mental health-related quality of life. The reason for cannabis use as well as frequency of use may be important considerations in predicting depression. Impact This is the first study that evaluates the associations among cannabis use, the purpose of cannabis use, HRQoL, exercise, depression and sleep in a nationally representative sample of US adults living with cancer. Frequent cannabis users are likely vulnerable to poorer mental health-related quality of life and depression, and non-medical cannabis use in frequent users was associated with depression. Given expanding medical cannabis legalization, these findings warrant further attention so that this information can be used by people living with cancer in decision-making for symptom self-management.