BACKGROUND AND AIMS: The global cannabidiol (CBD) market has expanded in recent years. Several studies suggest CBD use, whether for medical or recreational purposes, is on the rise; however, no systematic assessments of its prevalence have been conducted so far. This meta-analysis aimed to estimate the prevalence of CBD use in North America and Europe independently.

METHODS: Searches were conducted in PubMed, PsycINFO and Web of Science on 25 March 2025. A total of 43 studies (48 distinct samples; n = 388 447; 57.52% female) from North America (k = 30; n = 353 088) and Europe (k = 13; n = 35 359) were included in the analyses. The prevalence was estimated at five time periods (i.e. lifetime, past 12 months, past 30 days, past 7 days and daily use) separately for each continent region. Differences in prevalence estimates by sex, year of data collection and sample type (i.e. clinical versus community) were examined. Publication bias was estimated using several indicators, and the methodological quality of the studies was appraised using the Joana Brigg's Institute (JBI) checklist.

RESULTS: In preliminary analyses of heterogeneity there was evidence of differences in prevalence between North America and Europe across all time periods (P-value range: < 0.001-0.057). Consequently, the pooled prevalence estimates were calculated for both continental regions separately. In Europe, the pooled lifetime prevalence of CBD use was 12.8% [95% confidence interval (CI) = 0.06-0.25], 17.6% (95% CI = 0.11-0.28) in the past 12 months, 7.2% (95% CI = 0.02-0.21) in the past month, 4.3% (95% CI = 0.01-0.13) in the past week and 2.1% (95% CI = 0.01-0.08) daily. In North America, lifetime pooled estimates were 28.9% (95% CI = 0.2-0.39), 19.5% in the past 12 months (95% CI = 0.11-0.32), 12% in the past month (95% CI = 0.07-0.2), 10.5% in the past week (95% CI = 0.01-0.47) and 6.4% daily (95% CI = 0.03-0.13). Of the moderators tested, sample type statistically significantly influenced the meta-analyses. In Europe, clinical samples (25.6%) reported higher past-year prevalence of CBD use in comparison with community samples (11.6%), whereas in North America there was higher past-year use of CBD among community samples (26.1%) compared with clinical samples (4.1%).

CONCLUSIONS: Cannabidiol use appears to be more prevalent in North America compared with Europe.