California saw no overall increase in adult cannabis use from 2018 to 2023 following recreational legalization, but trends differed significantly by race/ethnicity, with increases among Black and American Indian/Alaska Native populations.
Cannabis policy researchers, health equity researchers, public health officials
No overall increase in California cannabis use after legalization, but trends varied significantly by race/ethnicity
What the researchers found
Multivariable analysis showed a flat overall trend in past 30-day cannabis use from 2018 to 2023. However, subgroup analyses revealed significant differences: Asian Americans had lower odds of use than Whites (AOR 0.60), while trends varied by race/ethnicity over time. The American Indian/Alaska Native group showed the most notable increase, and Black non-Hispanic populations also trended upward.
Why it matters
A major concern about cannabis legalization was that use would increase broadly. This California data suggests legalization did not drive an overall increase, but the divergent trends by race/ethnicity indicate that legalization may affect different communities differently, with potential equity implications.
The numbers in context
Flat overall trend 2018-2023; Asian Americans AOR 0.60 (CI: 0.43-0.85) vs Whites; significant race/ethnicity by time interactions; American Indian/Alaska Native showed notable increase; analysis controlled for sociodemographic factors; data from California Health Interview Survey
How the study worked
Analysis of the California Health Interview Survey (CHIS), a representative household survey, examining past 30-day cannabis use among adults across racial/ethnic groups from 2018 to 2023. Logistic regression adjusted for sociodemographic factors.
What this study cannot tell us
California-specific results may not generalize to other states, CHIS is a household survey excluding institutionalized populations, self-reported use subject to social desirability, 5-year window may not capture longer-term trends, some subgroup sample sizes may be small
How to read the evidence
Large representative state survey with 5 years of post-legalization data and adjusted analysis; strong population-level data for California
When this study was published
Published 2025
The bigger picture
The finding that legalization did not increase overall use but did change patterns across racial/ethnic groups challenges both "legalization will increase use" and "legalization affects everyone equally" narratives, pointing to the need for more nuanced monitoring and targeted prevention.
Questions still open
- Why did use increase among some racial/ethnic groups but not others? Do differences in cannabis retail access, marketing exposure, or cultural attitudes explain the disparate trends? Should prevention efforts be tailored by community?
Common questions
Did cannabis use increase in California after legalization?
Which groups showed changes in cannabis use after legalization?
Read the original research
Trends in Post Legalization Cannabis Use Among Ethnic Groups in California: 2018-2023.
Substance use & misuse, 1-8
Citation
Caetano, Raul; Paschall, M J; Vaeth, Patrice A C; Kaplan, Zoe. (2025). Trends in Post Legalization Cannabis Use Among Ethnic Groups in California: 2018-2023.. Substance use & misuse, 1-8. https://doi.org/10.1080/10826084.2025.2579709