Use of cannabidiol products in Canada, United States, Australia, Aotearoa New Zealand, United Kingdom and Germany: products, sources and reasons for use.

Wadsworth E.; Graham M.; Rychert M.; Krowartz E.; Pacula R.; Hoch E.; Freeman T.; Hammond D. · The International journal on drug policy · 2026

**Background & Methods** This cross-sectional study analyzed data from the 2024 International Cannabis Policy Study across six jurisdictions (Canada, United States, Australia, Aotearoa New Zealand, United Kingdom, and Germany) with 79,644 participants aged 16-65. The study compared CBD-only product use patterns, reasons for use, socio-demographic correlates, purchase sources, and associations with medical cannabis access across different regulatory environments using weighted estimates and multivariable regression analyses. **Key Findings** • CBD-only product use varied significantly by jurisdiction, with highest lifetime, past 12-month, and past month use in the United States and lowest in Australia and New Zealand. Oils (27.1%-46.8%) and edibles (19.8%-34.2%) were the predominant product types across all regions. • Pain (32.3%-49.3%), anxiety (30.4%-46.5%), and depression (24.2%-31.1%) were the most commonly reported reasons for CBD use across jurisdictions. Medical cannabis prescription use showed the strongest association with past 12-month CBD-only product use (adjusted relative risk ratio ranging from UK 3.42 to NZ 14.73). • In jurisdictions without legal recreational cannabis (UK, Australia, NZ), approximately one-third of CBD-only product users reported using these products as a substitute for inaccessible legal medical cannabis (UK 28.4%; Australia/NZ 39.6%). Purchase sources generally aligned with legal access pathways specific to each regulatory environment. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. **Evidence Quality** This is a large, multi-national descriptive survey with notable limitations. The study relies on self-reported data without clinical verification of CBD product composition or actual therapeutic efficacy. The cross-sectional design cannot establish causality. Variation in regulatory frameworks and CBD legal status across jurisdictions may introduce selection bias. The absence of standardized product definitions across regions and potential reporting bias regarding symptom management limits inference. The authors note the need for stronger evidence to guide policy, suggesting current literature remains insufficient for definitive clinical recommendations. Results are generalizable primarily to English-speaking countries with similar development levels.

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