A 2025 Nationwide Cross-Sectional Survey on Public Attitudes Toward the Legalization and Depenalization of Recreational Cannabis in Poland

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.

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).

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).

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).

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).

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).

Discussion

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.