Lifetime sexual violence and tobacco, alcohol, and cannabis use among French adults: A national survey.

Objective: Sexual violence can lead to significant health impacts, including higher risk of substance use. This study examines the association between lifetime experiences of sexual violence and substance use in a large nation-wide sample of French adults. Methods: Data were drawn from the 2017 Health Barometer, a cross-sectional survey of 25,319 French adults aged 18-75, conducted in Mainland France between January and July 2017. Five substance use outcomes were examined: daily tobacco use, heavy drinking, regular binge drinking, monthly cannabis use, and problematic cannabis use. Multivariable logistic regression models were used to assess the association between sexual violence and each of these outcomes. Results: A total of 9.5% of women and 2% of men reported having experienced sexual violence. In adjusted analyses, lifetime experience of sexual violence was associated with increased odds of all five substance use outcomes. Lifetime sexual violence was also linked to study outcomes in stratified analyses by sex, with particularly strong associations for monthly cannabis use (women aOR = 2.53, 1.90-3.34; men aOR = 2.10, 1.37-3.16). Conclusions: These findings support the need for integrated care addressing both sexual violence history and substance use among sexual violence victims-survivors.