Abstract
The legalization and depenalization of recreational cannabis is increasingly debated in Europe, including in Poland, where medical cannabis was legalized in 2017. Despite ongoing public discourse, up-to-date data on public attitudes toward recreational cannabis legalization remain limited. This study aimed to characterize public attitudes toward the legalization and depenalization of recreational cannabis in Poland.
This retrospective, cross-sectional, computer-assisted web interviewing–based nationwide survey was conducted between July 11 and 13, 2025, using an online questionnaire completed by a representative sample of 1113 Polish adults. The survey assessed support for recreational cannabis depenalization, perceived accessibility, attitudes toward personal possession laws, and views on the impact of medical cannabis legalization. Multivariable logistic regression identified factors associated with public attitudes.
Results showed 29.6% respondents supported full legalization of recreational cannabis, 39.6% favored depenalization (eg, legal possession of up to 100 g or 3 plants), and 18.7% perceived cannabis as easily accessible; 32.4% expressed concern that medical cannabis legalization may lead to increased recreational use. Support for legalization and depenalization was significantly associated with male sex, younger age (18–29 years), urban residence, active occupational status, and good household economic status.
Eight years after medical cannabis legalization, public opinion in Poland shows limited support for full recreational legalization but substantially greater acceptance of depenalization, revealing a clear policy gradient. Demographic factors of sex, age, and place of residence strongly shape public attitudes. These findings provide evidence to inform drug policy discussions in Poland and other Central and Eastern European countries.
Keywords: Public Health, Poland, Policy, Cross-Sectional Studies, Cannabinoids
Introduction
Recreational cannabis is one of the most widely used drugs globally [1–3]. Recreational cannabis refers to the non-medical use (eg, for relaxation, socialization, or mood enhancement) of cannabis products containing psychoactive compounds, primarily delta-9-tetrahydrocannabinol (THC) [4]. Contrary to the use of medical cannabis products prescribed by a doctor to treat selected health conditions, the use of recreational cannabis is driven by personal choice [5,6]. Recreational cannabis and medical cannabis are often regulated differently under the national or local laws in force [6,7].
The global prevalence of recreational cannabis use is estimated at 12% in countries where cannabis is legalized and 5.4% in non-legalized countries [8]. Between 2000 and 2024, the prevalence of cannabis use has increased in numerous countries, following the implementation of medical or recreational cannabis legalization policies [7]. Cannabis use is generally considered safer than alcohol or opioid consumption, but health risks are still present [8]. Recreational cannabis users can experience impairment of memory or motor coordination, anxiety, and some psychiatric comorbidities, including cannabis use disorder. Between 1990 and 2019, the global incidence of cannabis use disorder increased by 32.3% [9]. The highest incidence of cannabis use disorder is observed in North America, Australia, and Oceania [10].
There are multiple socio-cultural factors influencing the use of recreational cannabis [11–13]. The legalization of recreational cannabis initially occurred in countries and regions perceived as liberal. In 2012, local law on the use of recreational cannabis was passed in the United States in Colorado and Washington states [14]. Uruguay was the first country to pass a nationwide law on the legalization of recreational cannabis use, in December 2013 [15]. In 2018, the use of recreational cannabis was legalized at the national level in Canada [15]. Between 2018 and 2024, several countries, including Georgia, Malta, Luxembourg, Mexico, Thailand, South Africa, Germany, and the Czech Republic, passed national laws on legalization or decriminalization of recreational cannabis [15–17].
The increasing number of countries that passed national laws on recreational cannabis evoked a public discussion on cannabis policy. Legalization of recreational cannabis is considered a legal intervention that can reduce black market sales, improve the quality and standards of planting and distribution, generate tax revenue, and reduce the justice expenditures related to the criminal cases for possession of cannabis [18]. However, there are different regulatory models implemented, and the effect of legalization of cannabis on social behaviors and the public may differ across the countries [14,19,20]. Due to this fact, public institutions play an important role in monitoring social behaviors related to cannabis use after introducing legal frameworks for recreational cannabis use [19]. Moreover, the effect of changes in recreational cannabis laws on drug use initiation, mental health status, healthcare utilization, and crime-related events also requires monitoring and investigation.
Discussions on the potential applications of medical marijuana have been taking place in European countries, including Poland, for several years. These debates often reveal clear differences in approach, ranging from great interest and hope to caution or criticism toward the substance [20]. Poland is a European country that, due to historical, social, and religious conditions, is perceived as a rather conservative country [21,22]. However, shifting cultural norms, including the activity of influencers and top musicians, and changes observed in neighboring countries such as Germany and the Czech Republic that allowed for the use of recreational cannabis, make the topic of legalizing or decriminalizing the use of recreational cannabis widely present in the public debate [16,17]. In 2017, Poland legalized medical cannabis, and the use of cannabis-based medicines is allowed under medical supervision [21]. The legalization of medical cannabis contributed to the partial destigmatization of cannabis use and evoked public debate on further possibilities related to the decriminalization of recreational cannabis use.
Poland, as a sentinel case in Central and Eastern Europe, is characterized by conservative socio-cultural norms, Catholic influence, and external policy pressure from neighboring countries, such as Germany and the Czech Republic [16,17]. For many years, Poland has witnessed sustained public debate on potential legislative approaches to cannabis policy, most commonly centered on the decriminalization of marijuana, with some stakeholders also advocating for full legalization. Our study contributes to this discussion by providing empirical evidence from a context in which legalization is publicly debated yet does not appear politically imminent, thereby informing policy deliberations grounded in the current realities of the Polish setting.
Public opinion plays a critical role in shaping drug policy [16]. However, there is a lack of up-to-date nationwide data on public attitudes toward the legalization or decriminalization of the use of recreational cannabis in Poland. Lessons learned from the legalization of medical cannabis in Poland, as well as examples of neighboring countries, like Germany and the Czech Republic that passed laws on the recreational use of cannabis, may have a considerable effect on public attitudes toward the recreational use of cannabis in Poland. Therefore, this study aimed to characterize public attitudes toward the legalization of recreational cannabis in Poland as well as to identify factors associated with public support for the legalization of recreational cannabis. By identifying these factors, this study can contribute to the current debate on legal regulations and public policies on cannabis in Central and Eastern Europe. As this is a nationwide study, findings from this study can be used by policymakers and public health specialists to develop further strategies on cannabis.
Material and Methods
Study Design and Participant Recruitment
This study was conducted as a cross-sectional survey using an online questionnaire targeting the adult population of Poland. Data collection was conducted between July 11 and 13, 2025, via computer-assisted web interviewing. Respondents were selected from the Ariadna research panel, a long-standing internet-based sampling frame consisting of more than 110 000 registered users aged 18 years and older [23]. The panel is continuously maintained to reflect the sociodemographic structure of the Polish population [23].
Participation was entirely voluntary, and all respondents provided informed consent before beginning the survey. Responses were collected anonymously, and the study adhered to all ethical standards for human subjects research. The protocol received approval from the Bioethics Committee at the Medical University of Warsaw (approval No. AKBE/39/2025; issued February 24, 2025).
A stratified sampling design was used to ensure population-level representativeness. Stratification was based on key demographic criteria, including sex, age, geographic region, type of locality, and education level. Quotas were constructed in alignment with current demographic estimates published by Statistics Poland (Główny Urząd Statystyczny). The study was conducted on a nationwide random quota-based sample of over 1000 adults aged 18 years and older, using joint quota controls to reflect the population distribution across sex (2 categories) × age (5 categories) × place of residence size (5 categories), resulting in a total of 50 strata.
Survey Instrument and Measures
The questionnaire was specifically developed for this study based on current policy debates and empirical literature regarding cannabis regulation in Europe [15–19]. The analytical scope of the present report focuses on 4 closed-ended questions addressing key aspects of cannabis use and regulation in Poland.
The following 3 items assessed public attitudes toward cannabis policy: support for the full legalization of cannabis use (including recreational purposes), perceived ease of obtaining cannabis for non-medical use, and opinions regarding the legal possession of up to 100 g or up to 3 cannabis plants for personal use, similar to provisions in place in the Czech Republic. Moreover, 1 question concerned the impact of the legalization of medical cannabis in 2017 on the recreational use of cannabis. Response formats included binary options (yes/no) and 5-point Likert-type scales, ranging from “definitely no” to “definitely yes”. The instrument was pilot tested prior to deployment to ensure language clarity, cultural relevance, and internal consistency. The final completion time was approximately 8 minutes.
Demographic variables included sex, age, level of education (primary, secondary, tertiary), type and size of place of residence (rural, town <20 000; town 20 000 to 99 999; city 100 000 to 499 999; city >500 000), and employment status. These data facilitated subgroup analysis of public perceptions and policy attitudes.
Statistical Analysis
Statistical analyses were performed using IBM SPSS Statistics version 29 (IBM Corp, Armonk, NY, USA). Categorical variables are presented as frequencies and proportions, and were compared using the chi-square test.
Factors associated with public beliefs and perceptions regarding cannabis regulation were examined using logistic regression. Each sociodemographic characteristic was first evaluated in separate bivariable models. Variables that reached statistical significance in bivariable analyses were subsequently entered into a multivariable logistic regression model. Associations are reported as odds ratios (ORs) with 95% confidence intervals (95% CIs), and statistical significance was defined as P<0.05.
Results
The study population included 1113 adults (18–84 years), of which 54.4% were women, 48.2% had a university degree (higher education), 52.1% were currently married, and 37.6% lived in rural areas (Table 1). Detailed characteristics is presented in Table 1.
Table 1.
Characteristics of the study population (n=1113).
| Variable | n | % |
|---|---|---|
| Sex | ||
| Female | 605 | 54.4 |
| Male | 508 | 45.6 |
| Age group [years] | ||
| 18–29 | 153 | 13.7 |
| 30–39 | 217 | 19.5 |
| 40–49 | 211 | 19.0 |
| 50–59 | 205 | 18.4 |
| 60+ | 327 | 29.4 |
| Educational level | ||
| Higher | 536 | 48.2 |
| Less than higher | 577 | 51.8 |
| Currently married | ||
| Yes | 580 | 52.1 |
| No | 533 | 47.9 |
| Place of residence | ||
| Rural area | 419 | 37.6 |
| City below 20 000 residents | 145 | 13.0 |
| City with 20 000 to 99 999 residents | 219 | 19.7 |
| City with 100 000 to 499 999 residents | 187 | 16.8 |
| City ≥500 000 residents | 143 | 12.8 |
| Number of household members | ||
| 1 (living alone) | 191 | 17.2 |
| 2 | 405 | 36.4 |
| 3 or more | 517 | 46.5 |
| Having children | ||
| Yes | 701 | 63.0 |
| No | 412 | 37.0 |
| Living with children under 18 years | ||
| Yes | 311 | 27.9 |
| No | 802 | 72.1 |
| Occupational status | ||
| Active | 695 | 62.4 |
| Passive | 418 | 37.6 |
| Self-reported household economic status | ||
| Good | 525 | 47.2 |
| Moderate | 416 | 37.4 |
| Bad | 172 | 15.5 |
In this representative sample of adults in Poland (n=1113), when respondents were asked about public perceptions and attitudes, 29.6% declared support (15.3% answered “probably yes”, and 14.3%, “definitely yes”) for the full legalization of cannabis in Poland (ie, not only for medical purposes but also for entertainment or recreational purposes) (Table 2). Among the respondents, 18.7% declared that there are no difficulties in obtaining (purchasing) non-medical cannabis for recreational purposes in Poland. Support for the idea of legalizing in Poland the possession of up to 100 g of cannabis (or up to 3 cannabis plants) for personal use, similar to the regulations in the Czech Republic, was declared by 39.6% of respondents (20.2% answered “probably yes” and 19.4%, “definitely yes”). Overall, 32.4% of respondents declared concern that the legalization of medical cannabis might lead to increased recreational (non-medical) use (Table 2).
Table 2.
Public attitudes toward the legalization and depenalization of in Poland (n=1113).
| Variable | n | % |
|---|---|---|
| Do you support the full legalization of cannabis in Poland, ie, not only for medical purposes but also for entertainment (recreational) purposes? | ||
| Definitely no | 388 | 34.9 |
| Probably no | 211 | 19.0 |
| Probably yes | 170 | 15.3 |
| Definitely yes | 159 | 14.3 |
| Unsure | 185 | 16.6 |
| How would you assess the difficulty of obtaining (purchasing) non-medical cannabis for recreational purposes in Poland today? In your opinion, is it easy to obtain non-medical (recreational) cannabis in Poland today? | ||
| Definitely no | 66 | 5.9 |
| Probably no | 143 | 12.8 |
| Probably yes | 175 | 15.7 |
| Definitely yes | 100 | 9.0 |
| Unsure | 629 | 56.5 |
| Do you support the idea of depenalizing in Poland the possession of up to 100 g of cannabis (or up to 3 cannabis plants) for personal use, similar to the regulations in the Czech Republic? | ||
| Definitely no | 244 | 21.9 |
| Probably no | 195 | 17.5 |
| Probably yes | 225 | 20.2 |
| Definitely yes | 216 | 19.4 |
| Unsure | 233 | 20.9 |
| Are you concerned that the legalization of medical cannabis might lead to increased recreational (non-medical) use? | ||
| Definitely no | 183 | 16.4 |
| Probably no | 349 | 31.4 |
| Probably yes | 237 | 21.3 |
| Definitely yes | 124 | 11.1 |
| Unsure | 220 | 19.8 |
In multivariable logistic regression analyses, male sex (adjusted (a)OR: 1.87; 95%CI: 1.43–2.46; P<0.001), age 18 to 49 years (P<0.05), living in cities with 20 000 to 99 999 residents (aOR: 1.77; 95%CI: 1.22–2.56; P=0.003) or cities over 500 000 residents (aOR: 1.95; 95%CI: 1.28–2.97; P=0.002), and active occupational status (aOR: 1.46; 95%CI: 1.04–2.07; P=0.003) were significantly associated with higher levels of public support for the full legalization of cannabis in Poland (Table 3).
Table 3.
Factors associated with public support for the full legalization of cannabis in Poland (n=1113).
| Do you support the full legalization of cannabis in Poland, ie, not only for medical purposes but also for entertainment (recreational) purposes? Responses: “probably yes” or “definitely yes” | ||||||
|---|---|---|---|---|---|---|
| Variable | % | P | Bivariable logistic regression | Multivariable logistic regression | ||
| OR (95%CI) | P | aOR (95%CI) | P | |||
| Sex | ||||||
| Female (n=605) | 23.8 | <0.001 | Reference | <0.001 | Reference | <0.001 |
| Male (n=508) | 36.4 | 1.83 (1.41–2.38) | 1.87 (1.43–2.46) | |||
| Age group [years] | ||||||
| 18–29 (n=153) | 39.9 | <0.001 | 3.21 (2.08–4.95) | <0.001 | 3.04 (1.79–5.16) | <0.001 |
| 30–39 (n=217) | 38.2 | 3.00 (2.02–4.46) | <0.001 | 2.50 (1.54–4.05) | <0.001 | |
| 40–49 (n=211) | 36.0 | 2.72 (1.82–4.07) | <0.001 | 2.20 (1.38–3.51) | <0.001 | |
| 50–59 (n=205) | 25.9 | 1.69 (1.10–2.58) | 0.02 | 1.44 (0.90–2.30) | 0.1 | |
| 60+ (n=327) | 17.1 | Reference | Reference | |||
| Educational level | ||||||
| Higher (n=536) | 31.3 | 0.2 | 1.18 (0.91–1.53) | 0.2 | ||
| Less than higher (n=577) | 27.9 | Reference | ||||
| Currently married | ||||||
| Yes (n=580) | 27.4 | 0.1 | 0.81 (0.62–1.04) | 0.1 | ||
| No (n=533) | 31.9 | Reference | ||||
| Place of residence | ||||||
| Rural area (n=419) | 24.6 | 0.003 | Reference | Reference | ||
| City below 20 000 residents (n=145) | 24.1 | 0.98 (0.63–1.52) | 0.9 | 1.04 (0.66–1.63) | 0.9 | |
| City with 20 000 to 99 999 residents (n=219) | 35.2 | 1.66 (1.17–2.38) | 0.005 | 1.77 (1.22–2.56) | 0.003 | |
| City with 100 000 to 499 999 residents (n=187) | 31.6 | 1.41 (0.97–2.07) | 0.07 | 1.43 (0.96–2.12) | 0.08 | |
| City ≥500 000 residents (n=143) | 38.5 | 1.92 (1.28–2.87) | 0.002 | 1.95 (1.28–2.97) | 0.002 | |
| Number of household members | ||||||
| 1 (living alone) (n=191) | 26.7 | 0.4 | 0.79 (0.55–1.15) | 0.2 | ||
| 2 (n=405) | 28.4 | 0.86 (0.65–1.15) | 0.3 | |||
| 3 or more (n=517) | 31.5 | Reference | ||||
| Having children | ||||||
| Yes (n=701) | 26.7 | 0.006 | Reference | 0.006 | Reference | 0.8 |
| No (n=412) | 34.5 | 1.45 (1.11–1.88) | 0.95 (0.69–1.31) | |||
| Living with children under 18 years | ||||||
| Yes (n=311) | 32.5 | 0.2 | 1.21 (0.91–1.61) | 0.2 | ||
| No (n=802) | 28.4 | Reference | ||||
| Occupational status | ||||||
| Active (n=695) | 35.5 | <0.001 | 2.26 (1.70–3.01) | <0.001 | 1.46 (1.04–2.07) | 0.03 |
| Passive (n=418) | 19.6 | Reference | Reference | |||
| Self-reported household economic status | ||||||
| Good (n=554) | 29.1 | 0.2 | 0.86 (0.59–1.26) | 0.4 | ||
| Moderate (n=396) | 26.4 | 0.76 (0.57–1.01) | 0.06 | |||
| Poor (n=142) | 32.2 | Reference | ||||
Male sex (aOR: 1.46; 95%CI: 1.10–1.93; P=0.01), living in cities with 20 000 to 499 999 residents (P<0.05), and living with 1 person in a shared household (aOR: 1.56; 95%CI: 1.01–2.41; P=0.04) were significantly associated with public perception of non-medical (recreational) cannabis as easily accessible in Poland (Table 4).
Table 4.
Factors associated with public perception of accessibility of non-medical (recreational) cannabis in Poland (n=1113).
| In your opinion, is it easy to obtain non-medical (recreational) cannabis in Poland today? Responses: “probably yes” or “definitely yes” | ||||||
|---|---|---|---|---|---|---|
| Variable | % | P | Bivariable logistic regression | Multivariable logistic regression | ||
| OR (95%CI) | P | aOR (95%CI) | P | |||
| Sex | ||||||
| Female (n=605) | 21.3 | 0.004 | Reference | 0.004 | Reference | 0.01 |
| Male (n=508) | 28.7 | 1.49 (1.13–1.96) | 1.46 (1.10–1.93) | |||
| Age group [years] | ||||||
| 18–29 (n=153) | 32.0 | 0.007 | 1.80 (1.17–2.76) | 0.008 | 1.62 (1.00–2.64) | 0.05 |
| 30–39 (n=217) | 22.6 | 1.11 (0.73–1.68) | 0.6 | 0.92 (0.57–1.50) | 0.7 | |
| 40–49 (n=211) | 31.3 | 1.73 (1.17–2.57) | 0.006 | 1.44 (0.89–2.33) | 0.1 | |
| 50–59 (n=205) | 21.0 | 1.01 (0.66–1.55) | 0.9 | 0.86 (0.53–1.40) | 0.5 | |
| 60+ (n=327) | 20.8 | Reference | Reference | |||
| Educational level | ||||||
| Higher (n=536) | 22.9 | 0.2 | 0.83 (0.63–1.10) | 0.2 | ||
| Less than higher (n=577) | 26.3 | Reference | ||||
| Currently married | ||||||
| Yes (n=580) | 22.9 | 0.2 | 0.82 (0.62–1.08) | 0.2 | ||
| No (n=533) | 26.6 | Reference | ||||
| Place of residence | ||||||
| Rural area (n=419) | 21.0 | 0.08 | Reference | Reference | ||
| City below 20 000 residents (n=145) | 24.8 | 1.24 (0.80–1.94) | 0.3 | 1.31 (0.83–2.06) | 0.2 | |
| City with 20 000 to 99 999 residents (n=219) | 28.8 | 1.52 (1.04–2.21) | 0.03 | 1.59 (1.08–2.32) | 0.02 | |
| City with 100 000 to 499 999 residents (n=187) | 29.9 | 1.61 (1.09–2.38) | 0.02 | 1.68 (1.12–2.51) | 0.01 | |
| City ≥500 000 residents (n=143) | 22.4 | 1.08 (0.69–1.72) | 0.7 | 1.15 (0.72–1.85) | 0.6 | |
| Number of household members | ||||||
| 1 (living alone) (n=191) | 18.8 | 0.1 | Reference | Reference | ||
| 2 (n=405) | 24.9 | 1.43 (0.93–2.19) | 0.1 | 1.56 (1.01–2.41) | 0.04 | |
| 3 or more (n=517) | 26.7 | 1.57 (1.04–2.37) | 0.03 | 1.49 (0.96–2.30) | 0.08 | |
| Having children | ||||||
| Yes (n=701) | 24.0 | 0.5 | Reference | 0.5 | ||
| No (n=412) | 26.0 | 1.11 (0.84–1.47) | ||||
| Living with children under 18 years | ||||||
| Yes (n=311) | 27.3 | 0.2 | 1.21 (0.90–1.63) | 0.2 | ||
| No (n=802) | 23.7 | Reference | ||||
| Occupational status | ||||||
| Active (n=695) | 27.2 | 0.01 | 1.44 (1.08–1.93) | 0.01 | 1.21 (0.92–1.87) | 0.1 |
| Passive (n=418) | 20.6 | Reference | Reference | |||
| Self-reported household economic status | ||||||
| Good (n=554) | 26.2 | 0.4 | 1.00 (0.68–1.49) | 0.9 | ||
| Moderate (n=396) | 22.4 | 0.82 (0.60–1.10) | 0.2 | |||
| Poor (n=142) | 26.1 | Reference | ||||
Male sex (aOR: 1.62; 95%CI: 1.26–2.08; P<0.001), age 18 to 29 years (aOR: 1.78; 95%CI: 1.16–2.75; P=0.01), living in cities with over 20 000 residents P<0.05), and active occupational status (aOR: 1.43; 95%CI: 1.05–1.96; P=0.02) were significantly associated with public support for the depenalization in Poland of the possession of up to 100 g of cannabis (or up to 3 cannabis plants) for personal use (Table 5).
Table 5.
Factors associated with public support for the depenalization in Poland of the possession of up to 100 g of cannabis (or up to 3 cannabis plants) for personal use (n=1113).
| Do you support the idea of depenalization in Poland the possession of up to 100 g of cannabis (or up to 3 cannabis plants) for personal use, similar to the regulations in the Czech Republic? Responses: “probably yes” or “definitely yes” | ||||||
|---|---|---|---|---|---|---|
| Variable | % | P | Bivariable logistic regression | Multivariable logistic regression | ||
| OR (95%CI) | P | aOR (95%CI) | P | |||
| Sex | ||||||
| Female (n=605) | 34.4 | <0.001 | Reference | <0.001 | Reference | <0.001 |
| Male (n=508) | 45.9 | 1.62 (1.27–2.06) | 1.62 (1.26–2.08) | |||
| Age group [years] | ||||||
| 18–29 (n=153) | 47.7 | 0.002 | 2.04 (1.38–3.03) | <0.001 | 1.78 (1.16–2.75) | 0.01 |
| 30–39 (n=217) | 41.5 | 1.59 (1.11–2.27) | 0.01 | 1.27 (0.84–1.92) | 0.3 | |
| 40–49 (n=211) | 45.0 | 1.83 (1.28–2.62) | <0.001 | 1.45 (0.96–2.19) | 0.08 | |
| 50–59 (n=205) | 40.0 | 1.49 (1.04–2.15) | 0.03 | 1.23 (0.82–1.85) | 0.3 | |
| 60+ (n=327) | 30.9 | Reference | Reference | |||
| Educational level | ||||||
| Higher (n=536) | 37.3 | 0.1 | 0.83 (0.65–1.06) | 0.1 | ||
| Less than higher (n=577) | 41.8 | Reference | ||||
| Currently married | ||||||
| Yes (n=580) | 37.2 | 0.09 | 0.81 (0.64–1.03) | 0.09 | ||
| No (n=533) | 42.2 | Reference | ||||
| Place of residence | ||||||
| Rural area (n=419) | 34.8 | <0.001 | Reference | Reference | ||
| City below 20 000 residents (n=145) | 29.7 | 0.79 (0.52–1.19) | 0.3 | 0.81 (0.53–1.23) | 0.3 | |
| City with 20 000 to 99 999 residents (n=219) | 45.2 | 1.54 (1.11–2.15) | 0.01 | 1.59 (1.13–2.24) | 0.01 | |
| City with 100 000 to 499 999 residents (n=187) | 44.0 | 1.49 (1.05–2.12) | 0.03 | 1.49 (1.04–2.14) | 0.03 | |
| City ≥500 000 residents (n=143) | 49.0 | 1.79 (1.22–2.63) | 0.003 | 1.77 (1.19–2.62) | 0.005 | |
| Number of household members | ||||||
| 1 (living alone) (n=191) | 43.5 | 0.5 | 1.20 (0.86–1.68) | 0.3 | ||
| 2 (n=405) | 38.5 | 0.98 (0.75–1.28) | 0.9 | |||
| 3 or more (n=517) | 39.1 | Reference | ||||
| Having children | ||||||
| Yes (n=701) | 37.9 | 0.1 | 0.83 (0.65–1.06) | 0.1 | ||
| No (n=412) | 42.5 | Reference | ||||
| Living with children under 18 years | ||||||
| Yes (n=311) | 41.2 | 0.5 | 1.09 (0.84–1.43) | 0.5 | ||
| No (n=802) | 39.0 | Reference | ||||
| Occupational status | ||||||
| Active (n=695) | 44.7 | <0.001 | 1.79 (1.39–2.32) | <0.001 | 1.43 (1.05–1.96) | 0.02 |
| Passive (n=418) | 41.1 | Reference | Reference | |||
| Self-reported household economic status | ||||||
| Good (n=554) | 42.4 | 0.03 | 0.99 (0.70–1.40) | 0.9 | 1.13 (0.79–1.63) | 0.5 |
| Moderate (n=396) | 34.6 | 0.71 (0.55–0.93) | 0.01 | 0.78 (0.59–1.02) | 0.07 | |
| Poor (n=142) | 42.7 | Reference | Reference | |||
Age 18 to 29 years (aOR: 1.95; 95%CI: 1.30–2.93; P=0.001), living in cities with 20 000 to 499 999 residents (P<0.05), and good household economic status (aOR: 1.73; 95CI: 1.20–2.50; P=0.003) were significantly associated with public perception of the impact of legalization of medical cannabis in Poland (2017) on its recreational (non-medical) use (Table 6).
Table 6.
Factors associated with public perception of the effect of legalization of medical cannabis in Poland (2017) on its recreational (non-medical) use (n=1113).
| Are you concerned that the legalization of medical cannabis might lead to increased recreational (non-medical) use? Responses: “probably yes” or “definitely yes” | ||||||
|---|---|---|---|---|---|---|
| Variable | % | P | Bivariable logistic regression | Multivariable logistic regression | ||
| OR (95%CI) | P | aOR (95%CI) | P | |||
| Sex | ||||||
| Female (n=605) | 32.9 | 0.7 | 1.05 (0.81–1.35) | 0.7 | ||
| Male (n=508) | 31.9 | Reference | ||||
| Age group [years] | ||||||
| 18–29 (n=153) | 43.1 | 0.008 | 1.83 (1.23–2.72) | 0.003 | 1.95 (1.30–2.93) | 0.001 |
| 30–39 (n=217) | 31.3 | 1.10 (0.76–1.59) | 0.6 | 1.13 (0.77–1.64) | 0.5 | |
| 40–49 (n=211) | 36.0 | 1.36 (0.94–1.96) | 0.1 | 1.36 (0.94–1.98) | 0.1 | |
| 50–59 (n=205) | 26.8 | 0.88 (0.60–1.30) | 0.5 | 0.89 (0.60–1.31) | 0.5 | |
| 60+ (n=327) | 29.4 | Reference | Reference | |||
| Educational level | ||||||
| Higher (n=536) | 32.8 | 0.8 | 1.04 (0.81–1.33) | 0.8 | ||
| Less than higher (n=577) | 32.1 | Reference | ||||
| Currently married | ||||||
| Yes (n=580) | 31.4 | 0.4 | 0.90 (0.70–1.16) | 0.4 | ||
| No (n=533) | 33.6 | Reference | ||||
| Place of residence | ||||||
| Rural area (n=419) | 27.9 | 0.02 | Reference | Reference | ||
| City below 20 000 residents (n=145) | 30.3 | 1.12 (0.74–1.70) | 0.6 | 1.09 (0.72–1.66) | 0.7 | |
| City with 20 000 to 99 999 residents (n=219) | 36.1 | 1.46 (1.03–2.06) | 0.04 | 1.45 (1.02–2.07) | 0.04 | |
| City with 100 000 to 499 999 residents (n=187) | 41.2 | 1.81 (1.26–2.59) | 0.001 | 1.80 (1.25–2.59) | 0.002 | |
| City ≥500 000 residents (n=143) | 30.8 | 1.15 (0.76–1.74) | 0.5 | 1.16 (0.76–1.76) | 0.5 | |
| Number of household members | ||||||
| 1 (living alone) (n=191) | 29.3 | 0.2 | 0.76 (0.53–1.09) | 0.1 | ||
| 2 (n=405) | 30.4 | 0.80 (0.61–1.06) | 0.1 | |||
| 3 or more (n=517) | 35.2 | Reference | ||||
| Having children | ||||||
| Yes (n=701) | 31.4 | 0.3 | 0.88 (0.68–1.14) | 0.3 | ||
| No (n=412) | 34.2 | Reference | ||||
| Living with children under 18 years | ||||||
| Yes (n=311) | 33.4 | 0.7 | 1.07 (0.81–1.41) | 0.7 | ||
| No (n=802) | 32.0 | Reference | ||||
| Occupational status | ||||||
| Active (n=695) | 32.5 | 0.9 | 1.01 (0.78–1.31) | 0.9 | ||
| Passive (n=418) | 32.3 | Reference | ||||
| Self-reported household economic status | ||||||
| Good (n=554) | 41.3 | 0.03 | 1.62 (1.13–2.31) | 0.008 | 1.73 (1.20–2.50) | 0.003 |
| Moderate (n=396) | 31.5 | 1.06 (0.80–1.40) | 0.7 | 1.11 (0.83–1.47) | 0.5 | |
| Poor (n=142) | 30.3 | Reference | Reference | |||
Discussion
This study is the first national snapshot of public attitudes toward recreational cannabis in Poland after medical cannabis legalization (2017–2025), capturing a transitional moment 8 years after legalization and amid regional policy shifts. Findings from this study showed that 29.6% of adults in Poland support full legalization of recreational cannabis, and 39.6% support some form of depenalization, similar to those in practice in the Czech Republic. Among the respondents, one-quarter declared a lack of difficulties in obtaining cannabis for recreational purposes. Moreover, approximately one-third of respondents declared concerns that the legalization of medical cannabis in 2017 led to increased recreational (non-medical) use. In this study, sex, age, place of residence, and occupational status were the most important factors associated with public attitudes toward the legalization of recreational cannabis in Poland.
In 2017, Poland legalized medical cannabis [21]. The study by Los showed that cannabis users declare easy access to a prescription for medical cannabis in Poland, and medical cannabis from a pharmacy [21]. Dedicated cannabis clinics are a preferred source of prescriptions for medical cannabis over traditional doctors [21]. Findings from the small sample study on physicians in Poland (n=173) showed that Polish physicians favored the legalization of medical cannabis [24]. However, most doctors do not feel prepared for patient counseling on medical cannabis use [25], which can lead to shaping the wrong social perception of cannabis. The use of medical cannabis for health conditions is still developing as a medical field in Poland [26]. There was a wide public debate during the passing of the law on medical cannabis in Poland, including concerns about the effect of the law on social behaviors toward the use of cannabis for recreational purposes. The effect of medical cannabis legalization on the consumption of recreational cannabis is unclear, and scientific evidence is inconclusive [4–6,19]. In this study, 32.4% of respondents declared concerns that legalization of medical cannabis might lead to increased recreational (non-medical) use, but almost half of the respondents (47.8%) declared no such concerns. There is a social phenomenon in Poland whereby people without medical conditions may attempt to visit cannabis clinics (especially online visits) and receive prescriptions for medical cannabis for recreational use. This is considered a form of obtaining cannabis legally, but it involves relatively high costs of a private visit to a clinic and the cost of purchasing medical cannabis at a pharmacy. However, the extent of this phenomenon is not known. In this study, younger age, living in cities with populations of 20 000 to 499 999 residents, and good household economic status were significantly associated with public perception of the effect of the legalization of medical cannabis in Poland on the increased recreational (non-medical) cannabis use. This observation may identify groups likely to use medical cannabis for recreational purposes.
Recreational cannabis is offered on the black market. In this study, one-quarter of respondents declared a lack of difficulties in obtaining recreational cannabis, indicating it was easily accessible. At the same time, 56.5% of respondents declared that they did not know whether it is easy to obtain non-medical (recreational) cannabis in Poland, or they were not interested in the cannabis matter at all. This observation suggests that most Poles do not seek recreational cannabis and do not know how the black market works. Male sex was associated with the public perception of non-medical (recreational) cannabis being easily accessible. This may suggest that men buy cannabis more often on the black market than do women. This observation is in line with sex differences in the prevalence of use of recreational cannabis (higher rates are in men) [2,27]. Living in cities with populations of 20 000 to 499 999 residents was also associated with a perception of medical cannabis as easily accessible. This observation suggests that recreational cannabis is more accessible in medium-sized cities. Living with 1 person in a shared household was also associated with perception of recreational cannabis as accessible without difficulties, which may result from the fact that having roommates can increase the social network and access to black market products, such as recreational cannabis. Smith et al found that women were less likely to report willingness to use marijuana in the presence of less attractive men, whereas men were more likely to use it in the presence of attractive women. These findings suggest that the presence of an opposite-sex person influences drug use depending on their physical attractiveness and the participant’s sex [28]. The study by Clayton et al showed that substance use by friends and partners was most strongly associated with past and intended future use among respondents. Siblings had a smaller but noticeable influence, while parental behavior had only minimal influence [29].
Drug policies vary worldwide [14–17]. Some countries implemented complete legalization of recreational cannabis, whereas others implemented depenalization of possession and cultivation of a certain amount of cannabis for personal use [13–16,30]. There is a lack of a standardized model of public policies on cannabis use, and countries differ in the regulations, monitoring procedures, and legal obligations related to cannabis use. Findings from the present study showed that 29.6% of adults in Poland supported the full legalization of recreational cannabis. However, 53.9% opposed the full legalization of cannabis in Poland. This observation points out that there is a lack of strong opposition against the full legalization of cannabis. Male respondents, those aged 18 to 49 years, residents of cities with 20 000 to 99 999 residents or of cities with over 500 000 residents, and those with active occupational status were more likely to support full legalization of recreational cannabis in Poland. These sociodemographic differences may reflect that these groups are more likely to use recreational cannabis or hold liberal or libertarian views on public policy.
A higher level of social support was observed for some form of depenalization of recreational cannabis, as in the neighboring Czech Republic [15,16]. In this study, 39.6% of adults in Poland declared support for legalizing the possession of up to 100 g of cannabis (or up to 3 cannabis plants) for personal use, similar to the regulations in the Czech Republic. This observation suggests that some part of the depenalization of recreational cannabis in Poland has higher social support than full legalization. However, 39.4% of adults in Poland declared negative attitudes toward legalizing the possession of up to 100 g of cannabis (or up to 3 cannabis plants). Findings from this study showed that depenalization received more support than full legalization. This observation may indicate pragmatic rather than ideological reasoning. When compared with data from Germany and the Czech Republic, the policy gradient observed in this study may reflect broader trends in Central and Eastern Europe rather than a uniquely Polish phenomenon.
The percentage of Poles who declared support for legal changes based on the model of the Czech Republic was almost identical to the percentage of opponents of such a legal solution (39.6% vs 39.4%). This observation indicates a lack of clear social trends and attitudes toward the regulation of recreational cannabis use. Male sex, age 18 to 29 years, living in cities with over 20 000 residents, and active occupational status were significantly associated with public support for the legalization in Poland of the possession of up to 100 g of cannabis (or up to 3 cannabis plants) for personal use. A similar set of socio-demographic factors was associated with social support for the full legalization of recreational cannabis. Poland is a country with a relatively conservative socio-political landscape. Discussion on recreational cannabis depenalization and or legalization may be influenced by the influence of Catholic and legal traditions. Moreover, in further analyses, debates occuring after the 2017 normalization should be analyzed.
Practical Implications
This study provided data on public perceptions and attitudes toward public policies on cannabis, rather than actual cannabis use or behavioral change. Findings from this study may affect the national drug policy in Poland and may also be used by other Central and Eastern European countries to plan and develop policies on cannabis use and legal regulation. Eight years after the legalization of medical cannabis in Poland, most of the adults surveyed did not show clear support for the legalization of recreational cannabis. Decriminalization of recreational cannabis was more acceptable than full legalization. Sociodemographic differences in the public attitudes toward recreational cannabis, by sex, age, place of residence, and occupational status, point out socio-demographic groups that may be a target audience for educational campaigns on the health effects of the use of recreational cannabis. Moreover, data from Poland, the largest country in the Central and Eastern European region, can inform neighboring countries, such as Baltic countries or Slovakia, on further directions and public expectations toward drug policy. Different depenalization thresholds and enforcement practices may be implemented; therefore, further research is needed to provide more scientific data used for evidence-based public health policies.
Limitations
This study was limited to 4 key questions on public attitudes toward the legalization of recreational cannabis. A limited number of survey questions limits explanatory depth. Motivations for and against the legalization of recreational cannabis were not analyzed in this study. Moreover, this study is based on a quantitative cross-sectional survey, and in-depth qualitative interviews were not performed. The computer-assisted web-interview method was used for data collection, and approximately 4% of households in Poland that do not have an Internet connection were excluded from this study. There were no direct interactions with respondents; therefore, recall bias may have occurred. In this study, there was an absence of behavioral data and a limited depth of attitudinal measurement. Caution should be made against causal or policy extrapolation. Findings should be used to inform public and academic dialogue rather than serve as direct evidence for policy implementation. The methodological strength lies in the use of a representative, stratified national sample at a time of active policy debate. Computer-assisted web-interview panels are commonly used in biomedical research as a cost-effective and reliable method for assessing attitudes toward socially sensitive and legally ambiguous topics.
Conclusions
Eight years after medical cannabis legalization, public opinion in Poland shows limited support for full recreational legalization but substantially greater acceptance of depenalization, revealing a clear policy gradient. Incremental regulatory approaches may better align with current public expectations in Poland and potentially in other Central and Eastern European countries facing similar debates.
Footnotes
Financial support: None declared
Conflict of interest: None declared
Department and Institution Where Work Was Done: Work has been done in the Department of Community Psychiatry, Faculty of Health Sciences, Medical University of Warsaw, Poland.
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