Voters in Missouri and Maryland approved adult-use cannabis in the Nov. 8 election, while Arkansas, North Dakota, and South Dakota rejected ballot measures to allow it in their states.

Missouri, which adopted medical cannabis use in 2018, opted to allow cannabis use by adults 21 and over. Just over half (53.1%) of the participating 2 million voters approved the ballot measure, according to The Associated Press. The measure also included a 6% sales tax and expungement of arrest and conviction records of non-violent marijuana offenses, except for driving under the influence and sales to minors.

Meanwhile, nearly 66% of Maryland’s participating voters accepted a ballot measure permitting cannabis use for adults 21 and over. The measure also allows the state’s General Assembly to set a tax rate on cannabis sales. Maryland’s medical cannabis program became operational in 2017.

Just over 56% of Arkansas’ 889,425 participating voters rejected a ballot measure to expand cannabis use in the state, which adopted medical use in 2016. The measure would’ve set 10% sales tax on cannabis sales.

North Dakota, which voted to establish a medical cannabis program in 2016, opted not to expand cannabis use. Nearly 55% of the state’s 238,172 participating voters rejected the ballot measure. North Dakota voters also rejected a recreational use ballot initiative in 2018. 

Two years after approving medical cannabis use, voters in South Dakota rejected a ballot measure that would’ve allowed adult use. Nearly 53% of the state’s 347,397 participating voters rejected the measure.

South Dakota attempted to legalize medical and adult-use cannabis simultaneously in 2020, which would’ve made it the first state to go from prohibition to full legalization. However, in 2021,  the state’s Supreme Court ruled that the constitutional amendment to legalize adult-use cannabis was unconstitutional, since it violated South Dakota’s rule that proposed constitutional amendments must have only one subject.

As of Tuesday, 21 states - plus Washington, D.C. - allow adult-use cannabis. An additional 18 states offer medical cannabis programs.

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