15% of Americans Now Use Cannabis Monthly, With Distinct CBD-Only and Dual-Use Patterns

National survey data shows 15.4% of Americans used cannabis and 9.8% used CBD in the past month, with dual use peaking in young adults (18-25) and CBD-only use most common among seniors 65+.

Dai, Hongying Daisy et al.·Addictive behaviors·2026·Strong EvidenceCross-Sectional
RTHC-08199Cross SectionalStrong Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Strong Evidence
Sample
N=11,572

What This Study Found

In 2023, 8.9% of Americans were exclusive cannabis users, 3.4% exclusive CBD users, and 6.4% dual users. Dual use peaked at 10.8% among 18-25-year-olds. Exclusive cannabis use peaked at 14.8% among 26-34-year-olds. CBD-only use was most prevalent among adults 65+ (5.0%). State medical cannabis legalization was associated with higher exclusive cannabis use and dual use.

Key Numbers

56,705 total participants. 15.4% past-month cannabis use, 9.8% CBD use. Exclusive cannabis 8.9%, exclusive CBD 3.4%, dual use 6.4%. Dual use peak: 18-25 (10.8%). Cannabis peak: 26-34 (14.8%). CBD-only peak: 65+ (5.0%). Poor health: 3x higher odds of any use pattern. Medical legalization: 1.5x higher cannabis/dual use.

How They Did This

Analysis of the 2023 National Survey on Drug Use and Health. Adolescents (12-17, n=11,572) and adults (18+, n=45,133). Past 30-day cannabis and CBD use patterns examined. Multinomial regressions assessed associated factors including demographics, health status, and state cannabis policy.

Why This Research Matters

Cannabis and CBD are often discussed together but used by different populations for different reasons. Understanding these distinct patterns helps target public health messages and research priorities to the right groups.

The Bigger Picture

The finding that CBD-only use peaks in seniors while dual use peaks in young adults suggests very different motivations. Older adults may seek targeted symptom relief, while young adults may experiment with multiple cannabinoid products. Health status was the strongest predictor across all patterns.

What This Study Doesn't Tell Us

Self-reported use subject to recall and social desirability bias. Past 30-day window doesn't capture frequency or dose. CBD source (hemp vs. dispensary) not distinguished. Cross-sectional — cannot determine if health status drives use or vice versa.

Questions This Raises

  • ?Are seniors using CBD effectively for their health conditions?
  • ?Is dual use among young adults driven by experimentation or specific therapeutic goals?
  • ?How will further legalization shift these patterns?

Trust & Context

Key Stat:
Evidence Grade:
Large nationally representative survey with robust methodology — strong for describing population-level patterns.
Study Age:
Published in 2026 using 2023 NSDUH data, the most recent comprehensive national survey available.
Original Title:
CBD, cannabis, or both? Examining use patterns and associated factors among U.S. youth and adults.
Published In:
Addictive behaviors, 176, 108622 (2026)
Database ID:
RTHC-08199

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

How common is cannabis use in America?

In 2023, 15.4% of Americans reported past-month cannabis use and 9.8% used CBD products. Combined with dual users, about 1 in 5 Americans used some form of cannabinoid product monthly.

Do people use cannabis and CBD differently?

Yes — young adults (18-25) most commonly use both together, middle-aged adults (26-34) prefer cannabis alone, and seniors (65+) are most likely to use CBD only. Poor health status tripled the odds of any use pattern.

Read More on RethinkTHC

Cite This Study

RTHC-08199·https://rethinkthc.com/research/RTHC-08199

APA

Dai, Hongying Daisy; Puga, Troy B. (2026). CBD, cannabis, or both? Examining use patterns and associated factors among U.S. youth and adults.. Addictive behaviors, 176, 108622. https://doi.org/10.1016/j.addbeh.2026.108622

MLA

Dai, Hongying Daisy, et al. "CBD, cannabis, or both? Examining use patterns and associated factors among U.S. youth and adults.." Addictive behaviors, 2026. https://doi.org/10.1016/j.addbeh.2026.108622

RethinkTHC

RethinkTHC Research Database. "CBD, cannabis, or both? Examining use patterns and associate..." RTHC-08199. Retrieved from https://rethinkthc.com/research/dai-2026-cbd-cannabis-or-both

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.