Young adult cancer survivors and substance abuse: Results from the U.S. National Health Interview Survey, 1997-2009

Introduction
Though five-year cancer survival rates are increasing, young-adult survivors may experience health complications or physical late effects that contribute to negative lifestyle behaviors potentiating the use of gateway drugs (e.g. alcohol and cigarettes). Examination of these negative behaviors during young adulthood may be particularly critical, as this developmental period is characterized by significant change, identity-exploration, and experimentation. We examined the use of cigarettes and risky alcohol consumption among U.S. young-adult cancer survivors.

Methods
We analyzed data on U.S. young-adults age 18-24 participating in the 1997-2009 National Health Interview Survey (n=39,433), who reported on their cigarette-use, alcohol consumption, and socio-demographic characteristics. 

Results
Among all youth, youth-workers are almost twice as likely to smoke cigarettes when compared to their unemployed peers and Whites were more likely to engage in these negative behaviors when compared to their Black peers. Youths with cancer were less likely to be current smokers and drinkers when compared to young people without a cancer history. Within group, there is a similar pattern of alcohol and cigarette consumption among young people with and without cancer. While 68% of youth-workers were smokers and 71% current drinkers, 59% of young people with cancer were smokers and 64% current drinkers. 

Discussion
Periodic clinical assessments for substance use during young adulthood when baseline rates are relatively high compared to other ages are important. Research on processes involved in a young cancer survivors’ decisions to use substances will provide better insight regarding how best to intervene and who to include in educational interventions.