Prevalence and determinants of cigarette-cannabis co-use among US cancer survivors

Purpose We estimated the prevalence of cigarette-cannabis co-use and investigated the individual-level factors associated with cigarette-cannabis co-use among adult (aged >= 18) cancer survivors. Methods We used population-based data from the 2022 Behavioral Risk Factor Surveillance System. The sample included 9,323 (weighted 2,711,650) adult cancer survivors residing in 16 US states and two US territories. The outcome was cigarette-cannabis co-use, examined using multinomial multivariable logistic regression models. Results Overall, 81.83% self-reported as white, 58.97% women, and 57.69% aged >= 65. About 12.00% reported current cigarette use, 10.36% past 30-day cannabis use, and 3.28% cigarette-cannabis co-use. The odds of cigarette-cannabis co-use were greater for younger survivors (18-49 years), those with high school or less education, not in the workforce, and divorced, separated, widowed, or never married individuals. Further, survivors with >= 3 comorbidities (vs. no-comorbidity), >= 14 days of poor mental health days (vs. none), and >= 14 days of poor physical health (vs. none) in the past month also had increased odds of cigarette-cannabis co-use. Conclusions The study findings suggest that certain subgroups of cancer survivors are more likely to engage in cigarette-cannabis co-use, and these patterns are associated with individual-level factors. Implications for cancer survivors New strategies and tailored interventions targeting cigarette-cannabis co-use among cancer survivors are critically needed to improve the overall well-being of cancer survivors. Future research should explore additional factors to fully understand cigarette-cannabis co-use in cancer survivors.