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

Wanli Xu; Declan O Gilmer; Angela Starkweather; Kyounghae Kim

doi:10.1111/jan.14780

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

J Adv Nurs. 2021 May;77(5):2386-2397. doi: 10.1111/jan.14780. Epub 2021 Feb 17.

Authors

Wanli Xu^{1

2}, Declan O Gilmer³, Angela Starkweather^{1

2}, Kyounghae Kim^{4

5

6}

Affiliations

¹ School of Nursing, University of Connecticut, Storrs, CT, USA.
² Center for Advancement in Managing Pain, University of Connecticut, Storrs, CT, USA.
³ Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA.
⁴ College of Nursing, Korea University, Seoul, South Korea.
⁵ Institute of Nursing Research, Korea University, Seoul, South Korea.
⁶ Transdisciplinary Major in Learning Health Systems, Korea University, Seoul, South Korea.

PMID: 33599000
DOI: 10.1111/jan.14780

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.

Keywords: cancer survivors; cannabis; depression; exercise; quality of life; sleep.

MeSH terms

Adult
Cancer Survivors*
Cross-Sectional Studies
Depression / epidemiology
Humans
Marijuana Use*
Neoplasms*
Quality of Life
Sleep