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Financial Worry and Substance Use Among Cancer Patients

Is financial worry associated with substance use among people with cancer?

Key points

  • Financial worry is associated with tobacco use (cigarette smoking).
  • Financial worry is not associated with problematic use of cannabis, alcohol or prescription drugs.
  • Financial hardship should be addressed regardless of whether it could lead to problematic substance use.

One focus of my research is on the negative effects of financial hardship among people with cancer. Showing that financial hardship leads to a worse quality of life or earlier mortality would support finding ways to prevent and treat financial problems. While research, including my own, has shown that more financial hardship after cancer is associated with a worse quality of life, worse mental health, and earlier mortality, little research has investigated the role of substance use.

Image by Steve Buissinne from Pixabay
Image by Steve Buissinne from Pixabay

Substance use is a very broad term. It can refer to using a substance to cope with stress or avoid negative emotions. These substances can include tobacco, in the form of cigarettes, alcohol, cannabis (marijuana), and prescription drugs. Not all substance use is a problem. If substance use causes problems in a person’s life, such as relationship conflict or drunk driving, then it would be considered problematic substance use. Some substances, such as tobacco, are considered problematic at any level of use because of how strongly they are associated with diseases such as cancer or heart conditions.

My colleagues and I investigated whether financial worry was associated with problematic substance use in a sample of people with cancer. We looked at four types of problematic substance use: cannabis; alcohol; prescription drugs; and tobacco, specifically cigarette smoking. For the first three (cannabis, alcohol, prescription drugs), the use had to interfere with the person’s life to be considered problematic. For tobacco use, we studied any use of tobacco.

We had some interesting results. Financial worry was not associated with problematic cannabis, alcohol, or prescription drug use. However, people who were financially worried were more likely to be currently smoking cigarettes. This suggests that cancer survivors who have financial worries may also need support in quitting smoking but are unlikely to also have problems with the use of other substances. Conversely, cancer survivors trying to quit smoking might benefit from financial assistance.

I should mention some caveats. This was one study and more research is always needed. We know from research of people without cancer that cigarette smoking is associated with financial hardship. That provides support for our results. It is also important to note that financial hardship should be addressed regardless of whether it could lead to problematic substance use.

One reason I wanted to look at substance use and financial worry was several assumptions I have heard about people who experience financial hardship. I often hear people blame those with financial hardship, saying that they would not have financial problems if they stopped using alcohol or other drugs. While substance use might contribute to financial problems for some, overall it seems that blaming financial hardship on substance use is possibly a myth. The one exception is smoking cigarettes, which has been known to be associated with financial hardship, as mentioned above.


Jones SMW, Ton M, Heffner JL, Malen RC, Cohen SA, Newcomb PA. Association of financial worry with substance use, mental health, and quality of life in cancer patients. J Cancer Surviv. 2023 Jan 3. doi: 10.1007/s11764-022-01319-4. Epub ahead of print. PMID: 36595185.

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