Cancer survivors and providers differ in views on medical cannabis, study finds

Findings point to differences in risk perception, communication and confidence discussing cannabis in cancer care

Virginia Commonwealth University

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For many cancer survivors, cannabis has become part of how they manage symptoms such as pain, nausea and anxiety. Medical cannabis is now legal in 47 states, Washington, D.C., and three U.S. territories, and its use continues to grow among both the general population and cancer survivors. Yet despite its increasing use, little is known about how survivors and their healthcare providers view medical cannabis or how comfortable they are discussing it.

A new study from VCU Massey Comprehensive Cancer Center surveyed 395 cancer survivors and 62 cancer care providers to better understand those perspectives. Published in the Journal of Cancer Education, the study found that while survivors and providers agreed on many aspects of medical cannabis, they differed in their awareness of potential risks and their comfort discussing it.

“Both cancer survivors and healthcare providers share some similarities in their perceptions about using medical cannabis, but there are also gaps in perceived risk awareness and patient-provider communication,” said Sunny Jung Kim, Ph.D., the study’s corresponding author, a researcher in the Cancer Prevention and Control program at VCU Massey and an associate professor at the VCU School of Public Health.

For Kim, whose research focuses on cancer survivorship and pain management, the study grew out of a broader effort to identify alternatives to opioid-based care.

“People are seeking different approaches to avoid or reduce long-term opioid use, and cannabis is one of them,” Kim said.

The research findings

The study found that cancer care providers were significantly more likely than survivors to report awareness of the potential risks of cannabis use (25% vs. 8.4%). At the same time, cancer survivors were far more likely to say they felt comfortable discussing cannabis with their care team than providers were to say they felt comfortable bringing it up with patients (68.5% vs. 46.7%). Providers also held more negative attitudes toward recreational cannabis use than survivors did.

Among survivors, those who had used cannabis reported greater social well-being than those who had never used it, but also reported lower physical and emotional well-being, greater mistrust in the healthcare system and lower use of healthcare services overall. Cannabis-using survivors also had higher rates of smoking, vaping, anxiety and depression than non-users, though the two groups did not differ in chronic pain, alcohol use or sleep quality. Whether cannabis was legal in a survivor's state did not appear to influence whether they used it.

Notably, more than half (57.9%) of the survivors who used cannabis had started before their cancer diagnosis, while the rest began using it specifically in response to their diagnosis, a distinction Kim said may be clinically important.

“I see a similar pattern with opioids. Cancer survivors who were already using opioids before diagnosis are more likely to develop dependency or opioid-related problems,” Kim said. “I think something similar might apply to cannabis. People who were already using it recreationally before their cancer diagnosis may be more inclined to develop dependency or chronic cannabis use problems, so I think that group may need more careful attention.”

What's next?

“There should be stronger clinical evidence that clearly shows the benefits outweigh the potential risks. Standardized clinical guidelines regarding cannabis use for cancer survivors would also be helpful, and more education and training on this topic would give providers more confidence in discussing and recommending medical cannabis when appropriate,” Kim said.

Looking ahead, Kim said future studies should build that evidence through longitudinal research using biomarkers and other objective measures rather than relying solely on self-reported survey data.

“We need longitudinal studies establishing causality with biomarkers and objective measures,” Kim said. “The data shouldn't just be self-reported outcomes. It should be based on longitudinal follow-up data incorporating biomarkers and objective measures to evaluate the actual outcomes of medical cannabis use rather than perceived outcomes.”

Ultimately, Kim hopes the findings encourage more open conversations between cancer survivors and their healthcare providers about medical cannabis.

“Patient-provider communication is really critical. Having open discussions with providers will help reach informed decisions,” Kim said.

What is medical cannabis?

Medical cannabis refers to marijuana and its derivatives, including cannabis concentrates and cannabis-infused edibles, used to help manage symptoms or side effects of a medical condition.

Patients commonly use cannabis to try to manage pain, nausea, anxiety, depression, fatigue and loss of appetite, though evidence in cancer survivors is still evolving.

In this study, more than half of the survivors who used cannabis had started using it before their cancer diagnosis.

Collaborators

• Vanessa B. Sheppard, Ph.D., Professor and Theresa A. Thomas Memorial Chair in Cancer Prevention and Control, VCU Massey and VCU School of Public Health
• Farnese M. Motto, MSPH, Department of Social and Behavioral Sciences, VCU School of Public Health
• Susan Hong, M.D., director of the Cancer Survivorship Program, VCU Massey and VCU School of Medicine
• Aron H. Lichtman, Ph.D., Department of Pharmacology and Toxicology, VCU School of Medicine
• Hannah Ming, Ph.D., alumna of VCU
• Viktor Clark, Ph.D., research assistant professor, the University of Rochester Medical Center

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Journal

Journal of Cancer Education

DOI

10.1007/s13187-026-02934-w 

Article Title

Perspectives on Cannabis Use among Cancer Survivors and Cancer Care Providers: Parallel Surveys

 

Vaping or smoking found to reduce fitness in young people by 15%

European Respiratory Society

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Young people who vape or smoke cigarettes have reduced blood vessel functionality, breathing efficiency and exercise capacity compared to those who have never smoked or vaped, according to a study published today in ERJ Open Research.

Dr Azmy Faisal, the lead author of the study from the Manchester Metropolitan University, United Kingdom, explains: “In active, healthy young adults with normal lungs, both vapes and tobacco smoking led to worsened exercise capacity, shortness of breath, and intense leg fatigue.

“Like smoking, our research indicates that vaping can lead to harmful changes to the blood vessels, lung efficiency during exercise and approximately a 15% reduction in fitness compared to those who have never smoked or vaped.”

The study examined 75 people aged 18-30, a third had never smoked or vaped, a third were smokers but had never used vapes, and a third were vapers for approximately 3 years but had never smoked. All participants had normal resting lung function and similar lifestyles, including caffeine and alcohol consumption, and physical activity levels.

Each volunteer took part in an incremental cycle exercise test whilst having their heart, breathing and blood lactate responses measured at increasing difficulty until they reached their maximum. Ultrasound scans and blood tests were also done to look how well their arteries were functioning. Test results found that at their peak exercise ability, the vaping and smoking groups had significantly lower exercise capacity and oxygen uptake by approximately 15%. The lungs ability to blow out carbon dioxide was diminished and lactic acid built up quicker in vapers and smokers at all levels of exercise before they reached their maximum, resulting in increased breathlessness and leg discomfort compared to the group who had never smoked or vaped. Ultrasounds scans and blood samples showed signs of inflammation in the blood vessels. Researchers say these results suggest similar effects of vaping and smoking in young people.

Dr Faisal added: “These findings provide critical information for the general public, healthcare providers, and regulatory authorities regarding potential early risks associated with vape use, particularly for the growing number of young adults who have never smoked but choose to use these products. Additionally, our study supports the UK’s Tobacco and Vapes Act 2026, which prohibits vaping for individuals under 18 and aims to reduce vaping among young adults in the future.”

The team are now planning to conduct a series of MRI studies to better understand the changes within the heart, lungs and skeletal muscles associated with vaping, particularly the underlying mechanisms which lead to lower levels of fitness.

Dr Stamatoula Tsikrika from the European Respiratory Society’s expert group on tobacco, smoking control and health education, based at Sotiria Hospital, Athens, Greece, who was not involved in the research, said: “More and more young people who have never smoked are using vapes. As the popularity of vaping continues to rise, so too do concerns that it is becoming normalised behaviour, functioning as a gateway to nicotine addiction and introducing serious health risks.

“Vapes may contain lower levels of cancer-causing substances, but they can still trigger genetic changes such as DNA damage and inflammation, which are linked to increased lung cancer risk. For people who have never smoked, and are therefore not using vapes as a cessation method, the health consequences of vaping are becoming harder for policymakers and the tobacco industry to justify.”

Dr Tsikrika also commented on the Tobacco and Vapes Bill, passed in the United Kingdom earlier this year: “Ninety-four per cent of smokers start before they are 25 and 22% of 15-16 year olds in Europe are reported to use vapes, by establishing a generational sales ban on nicotine products, the UK has taken a monumental leap towards protecting the health of young people.”

(ends)

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Journal

ERJ Open Research

DOI

10.1183/23120541.00425-2026 

Method of Research

Observational study

Subject of Research

People

Article Title

Reduced vascular function, ventilatory efficiency, and exercise capacity in young adult E-cigarette users

Article Publication Date

14-Jul-2026

 

Research Alert: UC San Diego study tracks shifting US smoking norms over 30 years

University of California - San Diego

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A recent study from researchers at the Herbert Wertheim School of Public Health and Human Longevity Science at University of California San Diego developed and validated a new way to measure changing social norms around cigarette smoking and secondhand smoke exposure in the United States over the last three decades. Using data from 1.5 million respondents in the Tobacco Use Supplement to the Current Population Survey, researchers created a “Willingness to Restrict Smoking” (WTRS) scale that captures how strongly people believe smoking should be restricted in public settings. The results offer tobacco control programs a new way to evaluate their success and solve a decades-long challenge for researchers: how to effectively measure social norms around tobacco.

In the early 1990s, the National Cancer Institute (NCI) helped transform the public health approach to  tobacco control by shifting the focus from individual behavior change to changing social norms around smoking, particularly around where smoking should and should not be permitted. The California Tobacco Control Program (CTCP) became a leading example of this strategy, paving the way for California to successfully implement the world’s first smoke-free bar law in the late 1990s. This achievement was made possible by prior CTCP efforts to reshape attitudes toward smoking in bars through mass media campaigns featuring bar workers’ testimonials and targeted outreach to bar owners and employees. Since then, researchers and public health officials alike have sought a clear and reliable way to measure social norms around tobacco use.

The new study analyzed survey responses collected between 1992 and 2022 across all 50 states. Participants were asked whether smoking should be allowed in locations such as hospitals, workplaces, restaurants, shopping malls, bars, playgrounds and casinos. Researchers found that support for smoke-free environments increased steadily over time, particularly in indoor public spaces. Hospitals and playgrounds consistently received the strongest support for smoking restrictions.

The researchers say the findings support the long-standing public health strategy of reducing smoking by shifting social norms around secondhand smoke exposure. They also found that the scale remained stable and reliable across survey years despite changes in survey questions and settings over time. According to the study, the WTRS scale may offer tobacco control programs a new way to quantitatively evaluate whether campaigns and policies are successfully changing public attitudes toward smoking restrictions.

The study [“Social norms and the decline in US cigarette smoking: Evidence from 30 years of US representative surveys”], led by David Strong, PhD, professor at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science, published on June 17, 2026 in BMJ Public Health.

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Journal

BMJ Public Health

 

Fathers’ smoking habits influence teen vaping, new research shows

University of Nebraska-Lincoln

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A new study from the University of Nebraska–Lincoln sheds light on how parental smoking shapes adolescents’ attitudes and use of both traditional cigarettes and e‑cigarettes, finding that fathers’ behaviors may play a more influential role than those of mothers. 

Led by Alex Mason, a professor in the Department of Child, Youth and Family Studies, the research tracked 230 children from preschool through adolescence, examining how repeated exposure to smoking behaviors within the home affects later smoking and vaping behaviors by teens. The study collected self-reports on parental smoking habits during early childhood, including retrospective accounts of smoking during pregnancy, and later assessing teens’ attitudes toward and use of cigarettes and vaping devices.

The findings show that cumulative exposure to parental smoking over time significantly increases the likelihood that adolescents will both view smoking and vaping more favorably and engage in those behaviors themselves.

“With repeated exposure, as we suggest here, adolescents develop attitudes that are favorable to the substance, and then that results in smoking and vaping behaviors,” Mason said.

Most surprisingly, the researchers also found that a father’s smoking habits were more significantly linked to adolescent attitudes and use of cigarettes and e-cigarettes.

“I think our initial hunch would have been that mothers, more likely in the caregiving role and with prenatal exposure, would have more effect,” Mason said. “The father's role appears to be more salient — they're observing their father's smoking and being influenced by their father's attitudes.”

Mason pointed out that research into teen alcohol use follows a similar pattern, with paternal drinking exerting a stronger influence on future use. 

The research comes at a time when youth vaping use is trending upward. Data from the Nebraska High School Youth Tobacco Survey show that while cigarette use among high school students has dropped significantly, e‑cigarette use has climbed — from 19% reporting ever using e‑cigarettes in 2015 to 30% in 2022.

The 2024 National Youth Tobacco Survey found that 19% of students reported having used a tobacco product at some point, and about one in 10 high school students identified as current users. Vaping products are the most used product.

“Cigarette smoking plummeted to historic lows in terms of prevalence,” Mason said. “But of course, they quickly replaced that behavior with something else. Of the substances we’ve measured in our research — and we’ve assessed many others — by a long shot, vaping was the most prevalent, and we were seeing pretty high levels of vaping in kids at a young age.”

So what can parents do? 

Mason said this new research shows that early family intervention is needed to prevent children from becoming consumers of nicotine and tobacco products. He suggested, based on additional research literature, that parents who smoke or vape should avoid doing so in the presence of children and should have clear household rules and expectations that substance use is illegal and harmful. 

Mason is developing a new proposal for research into the effects of vaping on teens’ brain development. He noted that if children start vaping in their middle school or early teen years, by the time they graduate high school, they will have consumed the products for six or seven years. 

“We have very little understanding of what the consequences of that is for brain development,” he said. “It’s kind of an absurd experiment with our children’s health.”

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Journal

Drug and Alcohol Dependence

DOI

10.1016/j.drugalcdep.2026.113132 

Method of Research

Survey

Subject of Research

People

Article Title

Associations of parental smoking throughout childhood with adolescent smoking and vaping: Mediation via adolescent substance use attitudes

Article Publication Date

21-Jun-2026

 

TikTok content supports “illicit vape subculture” among teens

University of East Anglia

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Eleanor Bray, Research Associate at the University of East Angla

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Credit: University of East Anglia

TikTok content normalises illegal vaping among young people – according to research from the University of East Anglia (UEA). 

A new study shows that young people are far more likely to encounter illicit vaping content portrayed as normal, humorous and harmless on TikTok. 

Meanwhile evidence-based health advice on official health and education websites may fail to cut through the digital noise. 

That gap may be putting young audiences at risk, just weeks after The Tobacco and Vapes Act 2026 received royal assent, the team say. 

Dr Emma Ward, from UEA’s Norwich Medical School, said: “Our research shows that young people encounter very different messages about illicit vapes depending on where they look online.  

“While health and education websites tend to provide accurate, well-intentioned information about vaping in general, there is comparatively less information available about illicit vaping.  

“In contrast, TikTok content is far less regulated and often presents illegal vaping as conventional or even desirable. 

“These TikTok videos attract significant attention and can feed into an emerging illicit vape subculture, where young people exchange tips, experiences, and ways to bypass age restrictions.” 

The research found that some sellers actively glamorise illicit devices by marketing them as part of cosmetic or confectionery‑style ‘bundles’, a tactic the researchers say is designed to evade age verification. 

Dr Ward said: “This fragmented online environment is concerning. When accurate information is hard to find or feels unappealing, young people may turn instead to content that is more engaging but also more misleading, particularly on fast-growing video platforms like TikTok.”                 

How was the study carried out?  

To reflect what young people may encounter online, the researchers conducted systematic searches across both Google and TikTok. 

Educational and health websites were identified by reviewing the first six pages of Google search results, while TikTok content was analysed using popular hashtags linked to illicit vaping, including #noIDvape and #puffbundles. 

Research Associate, Eleanor Bray, from UEA’s School of Psychology, said: “By analysing both Google search results and TikTok content, we were able to compare formal health messaging with the informal content young people are most likely to consume day‑to‑day. 

“What stood out was how inconsistently illicit vaping is addressed across platforms. On TikTok, illegal products were sometimes actively glamorised, with vendors marketing devices through ‘bundle’ deals designed to evade age verification.” 

A Patient and Public Involvement and Engagement Representative (PPIE) with lived experience of vaping helped by looking over the findings and ensuring they accurately reflect youth experiences and relevance. 

Why does the research matter?  

The findings highlight an uneven online information landscape where accurate health advice struggles to compete with highly engaging social media content that can normalise or glamorise illegal vaping.  

Dr Ward said: “With the introduction of the Tobacco and Vapes Bill, our findings arrive at a critical moment. The research suggests that legislation alone will not be enough if video based platforms continue to expose young audiences to unregulated and misleading content.” 

Rather than turning away from social media, the researchers argue it should be embraced as part of the solution. 

Eleanor Bray said: “Public health messaging is more likely to be effective when it works with young people and the platforms they already use. To protect young audiences, we need online information that is not only accurate, but also accessible, engaging and relevant to their everyday lives.” 

This research was led by UEA’s Norwich Medical School.  

‘#NoIDVape: A content analysis of illicit vape messaging in young people’s information sources’ is published in Addiction Journal.  

ENDS 

NOTES TO EDITORS 

1/ For more information or to request an interview, please contact the UEA Communications office by emailing communications@uea.ac.uk. 

2/ A copy of the paper is available via the following Dropbox link: https://www.dropbox.com/scl/fo/6iaovpez9d50arp5r2uie/AOqmF39bXP1Wdv8sgTDwJns?rlkey=ugb6b56083nr1ngrharbb5pio&st=gxo8kpzg&dl=0

3/ The University of East Anglia (UEA) is a UK Top 25 university for research quality (Times Higher Education Rankings 2026) and UK 26th in the Complete University Guide. It also ranks in the World Top 60 (QS World Rankings for Sustainability 2025) and the World Top 20 for reduced inequalities and World Top 200 (Times Higher Education Impact Rankings 2025). Known for its world-leading research and good student experience, its 360-acre campus has won nine Green Flag awards in a row for its high environmental standards. The University is a leading member of Norwich Research Park, one of Europe’s biggest concentrations of researchers in the fields of environment, health and plant science. www.uea.ac.uk.    

 

 

 

 

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Journal

Addiction

DOI

10.1111/add.70476 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

‘#NoIDVape: A content analysis of illicit vape messaging in young people’s information sources’

Article Publication Date

1-Jun-2026

‘Open, Shameless Grift’: Right Before FDA Ruling on Vapes, Big Tobacco Company Gave $5 Million to a Trump Super PAC

“In the Trump administration, money beats MAHA every time.”


A young teenager vapes near the Boardwalk in Ocean City, Maryland on June 16, 2021.
(Photo by Shuran Huang for The Washington Post via Getty Images)

Stephen Prager
May 21, 2026
COMMON DREAMS

It was already known that President Donald Trump pressured top health officials to allow flavored vapes to hit the market after being leaned on by Big Tobacco executives earlier this month.

But The New York Times has revealed that the decision came just over a week after a massive super political action committee (PAC) donation from one of the cigarette companies looking to have the regulations lifted.


Report Details How Trump Did Big Tobacco’s Bidding on Flavored Vapes Despite Risk to Kids

Kenneth Vogel and Christina Jewett reported for the Times that on April 30, a subsidiary of the tobacco company Reynolds Americans—which owns Camel and Lucky Strike cigarettes—donated $5 million to the Trump-backed super PAC MAGA Inc., according to a financial report filed on Wednesday. It brought the total amount donated to the PAC up to $8 million.

The donation came just two days before tobacco industry executives held their sit-down with Trump at his golf club in Jupiter, Florida, where they told the president they were displeased with the FDA’s ban on flavored vapes, which was enacted in light of evidence that they were driving an epidemic of youth vaping.

According to a youth survey by the Centers for Disease Control and Prevention (CDC), the vast majority of middle- and high school-aged e-cigarette users prefer fruit and candy-flavored vapes.

The Times reported earlier this month that immediately after receiving an earful from executives at Reynolds and Philip Morris owner Altria, Trump rang Secretary of Health and Human Services Robert F. Kennedy, Jr., and Centers for Medicare and Medicaid Services head Mehmet Oz to complain about the FDA’s ban on e-cigarettes.

In the days that followed the meeting, Trump reportedly berated then-FDA Commissioner Marty Makary, who hesitated to reverse the policy due to the potential impact on children. Makary ultimately resigned less than a week later, along with RFK Jr.'s chief spokesperson, Rich Danker, citing disagreement about the e-cigarette policy change as the ultimate reason.

Within a week of the meeting with executives, the FDA announced it was dropping the ban on fruit-flavored vapes and authorizing the sale of mango and blueberry flavors by the Los Angeles-based company Glas Inc., which could pave the way for major cigarette makers to launch their own products on store shelves. It also allowed companies to add greater amounts of nicotine to pouches, which smokers often use in order to quit the habit.

Kush Desai, a spokesperson for the White House, told the Times that Reynolds’ $5 million donation to the MAGA Inc. PAC had nothing to do with the administration’s sudden shift in policy surrounding flavored vapes. He said “the only guiding factor behind the Trump administration’s health policymaking is gold standard science,” as well as “recent evidence that has found [vapes] can help adults quit smoking.”

A spokesperson for MAGA Inc. said his organization “is pleased to accept legal contributions from those who agree with President Trump’s America First agenda and his goal to make America great again.”

The $5 million donation is far from the only contribution Big Tobacco has made to Trump. As Common Dreams reported earlier this month:
Trump, who ran in 2024 on a pledge to “save vaping” as part of an effort to appeal to young voters, has raked in huge sums of money from the tobacco industry. According to data from OpenSecrets, his inaugural committee took over $3 million from vaping special interests, including $1.25 million from the Vapor Technology Association, and $1 million apiece from Altria and Breeze Smoke.

Altria, which owns Marlboro maker Philip Morris, and Reynolds American, which owns Lucky Strike and Camel, have also offered donations to Trump’s $400 million White House ballroom project. Reynolds, the biggest producer of menthol cigarettes, also gave $10 million to the super PAC backing Trump in 2024.

The Times also reported on Wednesday that a Reynolds executive was invited to a dinner hosted by Trump at the White House in October for donors who gave $2.5 million or more.



Critics described the $5 million donation as effectively a legal “bribe” to Trump and the latest example of the White House’s “open, shameless grift.”

It comes amid what seem to be endless reports of blatant self-dealing by Trump allies, most recently exemplified by the Trump-controlled Department of Justice’s settlement of a lawsuit from Trump against the Internal Revenue Service, which handed the president $1.8 billion in taxpayer funds that he plans to disperse to his allies as part of a so-called “weaponization fund,” which critics have dubbed a “slush fund.”

It’s also the latest example of Trump appearing to take actions in direct service of rich corporate donors—particularly in the fossil fuel, artificial intelligence, and cryptocurrency industries—or members of his family or personal inner circle.

Rep. Seth Magaziner (D-RI) also described the FDA’s policy change on vaping as a betrayal by the administration’s overseer, Kennedy. Though the HHS secretary has built his brand on pledges to “Make America Healthy Again” by decoupling corporate interests from health policy, he has been accused of bending to industry pressure on everything from food regulation to cancer-causing pesticides.

“In the Trump administration,” Magaziner said, “money beats MAHA every time.”