Cannabis Use Did Not Increase Overall in California After Legalization, But Trends Varied by Race

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.

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.

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 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.

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