Background: Recreational cannabis legalization has potentially important implications for occupational health and safety, as cannabis use at work has been associated with work-related injuries. However, little research examines the extent that cannabis legalization impacts trends in workplace cannabis use.

Objective: The current study analyzed the prevalence of cannabis use at work, including by state-level cannabis laws, occupational risk, and medical cannabis use.

Methods: Data are cross-sectional from wave 6 (2023) of the International Cannabis Policy Study and includes 26,458 respondents from the US. Regression models examined trends in workplace cannabis use across state-level cannabis laws, occupational risk, reasons for cannabis use and sociodemographic characteristics among all workers, past 12-month consumers, and consumers from states with legal medical cannabis.

Results: Overall, 7.8% of workers and 20.9% of past 12-month cannabis consumers reported using cannabis at or within two hours of work in the last 30 days. Workplace cannabis consumption was highest among workers in states with ‘recreational’ cannabis laws than medical (OR=1.37, p=0.004) or illegal states (OR=1.51, p<0.003). Workers in high-risk jobs were more likely to use cannabis at work than those in lower risk jobs (OR =1.60, p<0.001). Workplace cannabis use was also greater among those using cannabis for medical versus recreational (OR = 2.36, p < 0.001) or mixed reasons (OR = 1.74, p<0.001).

Implications: Results suggest that cannabis use in the workplace is prevalent, particularly in occupational settings with greater safety concerns. The findings highlight the need for greater research and understanding of substance use in the workplace.