Cannabis use among US adults with children at home increased with both medical and recreational legalization | Research

The takeaway

Among 287,624 US adults with children in the home (2004-2017), cannabis use was higher in states with recreational laws (11.9% past-month, 4.2% daily) than medical-only states (9.3%, 3.2%) or non-legal states (6.1%, 2.3%).

Cannabis policy makers, pediatric health officials, family health researchers

11.9% past-month use in recreational states vs. 6.1% in non-legal states among parents

What the researchers found

Recreational cannabis laws were associated with higher past-month use (AOR=1.28) and daily use (AOR=1.25) among adults with children. Medical laws also increased use (AOR=1.12 past-month, AOR=1.16 daily). Recreational legalization increased use broadly across demographics, while medical legalization effects were concentrated among adults 50+ and higher socioeconomic groups.

Why it matters

Cannabis use by adults with children in the home raises questions about secondhand exposure, safe storage, and parenting while impaired. Understanding how legalization affects this specific population helps inform family-focused policies.

The numbers in context

N=287,624; 2017 past-month use: 11.9% (RML), 9.3% (MML), 6.1% (no legal); daily use: 4.2% (RML), 3.2% (MML), 2.3% (no legal); RML AOR=1.28 past-month, 1.25 daily; MML AOR=1.12 past-month, 1.16 daily; MML effects strongest in adults 50+ and high SES

How the study worked

Difference-in-difference analysis of 2004-2017 NSDUH data (n=287,624 adults with children in the home). Compared cannabis use across states with recreational laws, medical laws, and no legal cannabis, adjusting for demographics and state-level tobacco control.

What this study cannot tell us

Repeated cross-sectional data, not individual-level longitudinal tracking. Self-reported cannabis use likely underestimated. State-level policy is a proxy for individual-level access. Cannot control for all state-level confounders.

How to read the evidence

Large nationally representative sample with rigorous difference-in-difference methodology and multiple years of data.

When this study was published

Published in 2021 using 2004-2017 NSDUH data.

The bigger picture

The finding that recreational legalization increases use broadly while medical legalization affects mainly older, higher-SES adults suggests different populations respond to different policy signals, requiring tailored public health approaches.

Questions still open

Does increased parental cannabis use translate to increased pediatric exposure incidents? Are there protective factors within families that moderate the risk of child harm?

Common questions

Do parents use more cannabis in legal states?

Yes. Past-month cannabis use among adults with children was nearly twice as high in recreational states (11.9%) as in non-legal states (6.1%). Daily use was also higher (4.2% vs. 2.3%).

Did legalization affect all parents equally?

Recreational legalization increased use broadly across demographics. Medical legalization had more targeted effects, primarily increasing use among adults over 50 and those with higher income and education.

Read the original research

Trends in cannabis use among adults with children in the home in the United States, 2004-2017: impact of state-level legalization for recreational and medical use.

Addiction (Abingdon, England), 116(10), 2770-2778

View on PubMed ↗Publisher’s paper ↗

Citation

Goodwin, Renee D; Kim, June H; Cheslack-Postava, Keely; Weinberger, Andrea H; Wu, Melody; Wyka, Katarzyna; Kattan, Meyer. (2021). Trends in cannabis use among adults with children in the home in the United States, 2004-2017: impact of state-level legalization for recreational and medical use.. Addiction (Abingdon, England), 116(10), 2770-2778. https://doi.org/10.1111/add.15472