About 10% of Kentucky adults used cannabis in 2020-2021, below the national average of 13%, but 42% of those users consumed it daily or near-daily, and most cited medical reasons.
Kentucky policymakers, public health researchers, and cannabis legalization observers
42% of Kentucky cannabis users consumed daily or near-daily
What the researchers found
Kentucky's cannabis use prevalence (10%) was lower than the national average (~13%). Among users, 42% used daily or near-daily. About 43% used cannabis for both medical and recreational reasons, 24% for medical only, and 33% for recreation only. Smoking was the dominant mode of use (78%).
Why it matters
Kentucky was preparing for legal medical marijuana in 2025. This baseline snapshot of use patterns before the legal market opens provides critical data for tracking how legalization changes behavior, particularly the high rate of daily use and medical motivation.
The numbers in context
10% current use in Kentucky vs ~13% nationally. 42% of users consumed daily or near-daily. 78% smoked cannabis. 43% used for both medical and recreational reasons. Male, 18-34 age group, never married, Black, lower education, lower income, and Central region residents were more likely to use.
How the study worked
Analysis of pooled 2020-2021 Kentucky Behavioral Risk Factor Surveillance System (BRFSS) data using weighted responses. Multivariable logistic regression identified characteristics associated with cannabis use across three geographic regions.
What this study cannot tell us
BRFSS is telephone-based and may miss certain populations. Self-reported cannabis use in a state where it was illegal may be underreported. Two years of data provides limited trend information. The three-region geographic analysis may mask within-region variation.
How to read the evidence
Population-based survey using established BRFSS methodology, though limited to two years and subject to self-report bias in an illegal-use context.
When this study was published
2024 study using 2020-2021 data
The bigger picture
The finding that two-thirds of Kentucky cannabis users cited medical reasons (alone or combined with recreation) in a state where it was illegal supports the argument that medical cannabis programs formalize already-existing use patterns rather than creating new ones.
Questions still open
- How will Kentucky's cannabis use patterns change after the medical market opens in 2025? Will daily use rates increase, decrease, or shift to different modes? Will the medical-recreational motivation breakdown change?
Common questions
How common was cannabis use in Kentucky before legalization?
Why were Kentucky residents using cannabis?
Read the original research
Population-based cross-sectional analysis of cannabis use among Kentucky adults, 2020-21.
Journal of cannabis research, 6(1), 44
Citation
Shafer, Sydney; Kennedy, Gunnar; Christian, W Jay. (2024). Population-based cross-sectional analysis of cannabis use among Kentucky adults, 2020-21.. Journal of cannabis research, 6(1), 44. https://doi.org/10.1186/s42238-024-00251-x