Cannabis Use in Georgia Barely Changed After Legalization

Lifetime cannabis use prevalence among Georgian young adults was similar before and after legalization (17.3% in 2015 vs 18.1% in 2022). Annual prevalence also held steady (7.0% vs 7.7%). However, cannabis became easier to obtain (OR 0.5 for difficulty), and the average age of first use increased from 18.1 to 19.1 years. Males and people who gambled were at higher risk of use.

Comparison of two nationally representative cross-sectional surveys of Georgian adults aged 18-29, conducted in 2015 (n=1,308) and 2022 (n=758), using bivariate analyses and multivariable logistic and linear regressions.

Georgia (the country) provides a unique natural experiment in cannabis legalization outside of North America and Europe. The finding that use rates did not increase despite easier access challenges the assumption that legalization inevitably leads to more use.

This adds to a mixed international picture on legalization outcomes. Some jurisdictions have seen use increases post-legalization while others, like Georgia, show minimal change. Cultural context, enforcement, and market development likely play significant roles.

Repeated cross-sectional design (not longitudinal) limits causal inference. Only four years post-legalization, which may not capture longer-term trends. Georgia's cannabis market may be less commercialized than North American markets, limiting comparability. Relatively small sample size for the 2022 survey.