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

Background Cannabidiol (CBD) has attracted scientific, clinical, and public interest due to its perceived therapeutic benefits and favourable safety profile. However, a gap remains in understanding how different CBD-only regulatory frameworks shape consumers interaction with the CBD-only market. The study aimed to compare across jurisdictions: 1) CBD-only product use; 2) use for mental/physical symptom management; 3) socio-demographic correlates; and 4) sources of purchase; and 5) to estimate associations between CBD-only product use and perceived access to medical cannabis in jurisdictions without legal recreational cannabis. Methods Data were from the 2024 International Cannabis Policy Study, national cross-sectional surveys among participants aged 16-65 in Canada (CA), United States (US), Australia (AU), Aotearoa New Zealand (NZ), United Kingdom (UK), and Germany (DE) (n=79,644). Weighted estimates of CBD-only product use and behaviours were calculated, and multivariable regression analyses were conducted to examine correlates. Findings Lifetime, past 12-month and past month CBD-only product use was the highest in the US and lowest in AU and NZ. Sources of purchase varied by jurisdiction but generally reflected legal access pathways. Oils (between US 27.1% and NZ 46.8%) and/or edibles (between AU 19.8% and US 34.2%) were the most reported product types. Pain (between UK 32.3% and NZ 49.3%), anxiety (between DE 30.4% and US 46.5%), and depression (between UK 24.2% and AU 31.1%) were the most reported reasons for use. The use of cannabis for medical purposes with a prescription had the strongest association with past 12-month use of CBD-only products (range: UK ARR=3.42- NZ ARR=14.73). In UK, AU, and NZ, close to a third of respondents who had ever used a CBD-only product reported to do so because they could not legally access medical cannabis ( UK 28.4% and AU/NZ 39.6%). Conclusion There is wide cross-jurisdictional variation in CBD-only product use and retail access pathways reflecting distinct regulatory environments, alongside consistent patterns in products, and reasons for use. Variation in the relationship between CBD-only product use and medical cannabis systems, combined with the use of CBD-only products for managing anxiety, depression, and pain, underscores the need for clearer public health messaging, consumer guidance, and stronger evidence to guide policy and practice.