Abstract
Background: As the population of people with CF (pwCF)
continues to age, attention is shifting towards addressing the unique
challenges teenagers and adults face, including substance use. Changing
attitudes and legality regarding marijuana and CBD may influence their
use among pwCF, but data on their prevalence, reasons for use, and
administration methods are lacking. Objective: Investigate
marijuana, cannabidiol (CBD), e-cigarette, and cigarette usage among
pwCF and explore differences in demographics, disease severity, and CFTR
modulator use between current and non-users. Methods: This
cross-sectional study used a one-time electronic survey to assess
marijuana, CBD, e-cigarette, and cigarette use in pwCF aged
>13 years. Demographic and clinical characteristics were
compared between current users and non-users. The association between
current substance use and CFTR modulator use was analyzed using logistic
regressions. Results: Among 226 participants, 29% used
marijuana, 22% used CBD, 27% used e-cigarettes, and 22% used
cigarettes. Current users of all substances were more likely to be
college-educated, Black, or aged 29-39 years than non-users. Current
e-cigarette users were 2.9 times more likely to use CFTR modulators
(95% CI 0.98-11.00, p=0.08) and current marijuana users were 2.5 times
more likely to use CFTR modulators compared to non-users, adjusted for
confounders. Current users of CBD, e-cigarettes, and cigarettes were
more likely to have an abnormal mental health screen compared to
non-users. A high proportion of never-users of marijuana and CBD
expressed interest in using. Conclusion: Substance use is more
prevalent among pwCF than previously reported and needs to be addressed
by healthcare providers.