National survey reveals how Americans use cannabis: smoking dominates but multimodal use is rising | Research

The takeaway

Among 119,000 US adults surveyed in 2023, 14.7% used cannabis in the past month, with 77% smoking it, though multimodal use was associated with more frequent consumption.

Public health planners, cannabis epidemiologists, tobacco control researchers

14.7% of US adults used cannabis in the past 30 days (2023)

What the researchers found

Past-30-day cannabis use was reported by 14.7% of 119,068 adults. Among users, 77.1% smoked, 44.3% ingested edibles, 32.7% vaped, and 14.0% dabbed. Most commonly, individuals either exclusively smoked (35.4%) or exclusively ingested (15.2%). Exclusive vaping was uncommon (3.1%), though many vapers used multiple methods. Multimodal use was associated with increased frequency. Strong correlations existed between tobacco smoking and cannabis smoking (OR 3.65) and between e-cigarette and cannabis vaping (OR 3.58).

Why it matters

Understanding how people actually use cannabis is essential for public health planning. The strong correlations between cannabis and tobacco delivery methods suggest shared behavioral patterns, while the rise of multimodal use may indicate escalating consumption patterns.

The numbers in context

n=119,068; 14.7% past-30-day use; 77.1% smoke; 44.3% ingest; 32.7% vape; 14.0% dab; 35.4% exclusively smoke; 15.2% exclusively ingest; 3.1% exclusively vape; tobacco-cannabis smoking OR 3.65; e-cig-cannabis vaping OR 3.58

How the study worked

Analysis of 119,068 individuals who answered cannabis questions in the 2023 Behavioral Risk Factor Surveillance System (BRFSS), a national cross-sectional survey. Cross-tabulations and logistic regression examined use patterns by demographics, health, and substance use. Negative binomial regression examined frequency correlates.

What this study cannot tell us

Cross-sectional BRFSS data relies on self-report. States participating in cannabis modules may not be nationally representative. Cannot assess dose, potency, or THC/CBD content by method. Past-30-day window may not capture occasional users.

How to read the evidence

Very large national survey with rigorous methodology provides strong descriptive evidence of cannabis use patterns, though self-report and cross-sectional design are inherent limitations.

When this study was published

2025 publication analyzing 2023 BRFSS data

The bigger picture

As cannabis markets diversify with edibles, vapes, and concentrates, use patterns are evolving beyond traditional smoking. This national snapshot shows that while smoking still dominates, a substantial minority uses multiple methods, and delivery method choice is strongly linked to other substance use behaviors.

Questions still open

Does multimodal cannabis use lead to higher total THC exposure? Will edible-only use continue to grow as smoking declines culturally?

Common questions

What is the most common way Americans use cannabis?

Smoking remains the most common method (77.1% of users), followed by edibles (44.3%), vaping (32.7%), and dabbing (14.0%). Many users employ multiple methods.

Is there a link between how people use cannabis and tobacco?

Yes. Tobacco smokers were 3.65 times more likely to smoke cannabis, and e-cigarette users were 3.58 times more likely to vape cannabis, suggesting delivery method preferences carry across substances.

Read the original research

Method and frequency of cannabis use: Results from the 2023 Behavioral Risk Factor Surveillance System.

Addictive behaviors, 170, 108418

View on PubMed ↗Publisher’s paper ↗

Citation

Amrock, Stephen M; Brar, Karmen; Pennington, Nicolette; Sajkiewicz, Agata J. (2025). Method and frequency of cannabis use: Results from the 2023 Behavioral Risk Factor Surveillance System.. Addictive behaviors, 170, 108418. https://doi.org/10.1016/j.addbeh.2025.108418