In just a few short years, cannabidiol (CBD) has emerged from the crowded field of natural health supplements into a mainstream consumer product. Today, CBD can be found in a wide variety of shapes and sizes, from body lotions to dog treats. No longer limited to the shelves of dispensaries, American consumers can now purchase CBD products in supermarkets and drugstores—this June, grocery giant Kroger announced it would sell CBD products in 945 stores.

CBD is a chemical compound that can be extracted from cannabis and hemp plants. Unlike tetrahydrocannabinol (THC), another component derived from cannabis plants, CBD has no psychoactive properties.

The meteoric rise of CBD popularity in the United States is due in large part to its long list of reported health benefits. While it’s important to note that the body of research surrounding CBD is still in its early stages, there have been a number of promising studies showing that CBD could be effective in treating the painful symptoms of conditions like arthritis, reducing the incidence of diabetes, and helping patients who suffer from mental disorders such as depression and anxiety.

CBD has also been shown to treat common health issues including poor sleep habits and high blood pressure. Another study published in 2013 showed that CBD usage reduced the number of cigarettes smoked by 40 percent in smokers attempting to quit compared to participants who received a placebo.

The most promising development of all may be CBD’s ability to alleviate common symptoms affecting cancer patients, including nausea, loss of appetite, and pain resulting from inflammation. Some research suggests that CBD could be used to treat cancer itself, although more work is needed.

Side effects related to CBD consumption are generally rare, however the National Center for Biotechnology Information (NCBI) does report that the most common side effects related to CBD use include tiredness or fatigue, diarrhea, nausea, changes in appetite or weight, dry mouth, and low blood pressure.

For most prospective CBD users, the biggest concern isn’t the side effects, but rather the ambiguity surrounding the legality of CBD in the United States. To understand the legality of CBD in a given state, the most important distinction to be aware of is whether a given CBD product is derived from hemp or marijuana.

As of last year, according to the Agriculture Improvement Act of 2018  all hemp-derived CBD (CBD containing less than 0.3 percent THC) is federally legalized. While a majority of CBD products are hemp-derived, there are some derived from marijuana, in which case they may contain more than 0.3 percent THC and are not federally legalized under the government’s definition of industrial hemp.

Despite CBD’s legal status at the federal level, some states—including Idaho, Nebraska, Texas, South Dakota, and Maine—initially opted to keep hemp-based products illegal. While Texas and Maine have since legalized hemp production and sale, hemp-derived CBD is still illegal in Idaho, Nebraska, and South Dakota. The legality of marijuana-derived CBD varies on a state-by-state basis.

In light of CBD’s reported health benefits and with the legality around hemp- and marijuna-sourced products rapidly changing, researchers at the CBD Awareness Project wanted to identify the cities whose residents would benefit most from CBD. To identify these cities, the researchers created a composite index for cities based on the prevalence of conditions that CBD has been shown to help alleviate the symptoms of. These conditions include:

  • Poor mental health (including depression and anxiety)
  • Poor sleep habits
  • Arthritis
  • Diabetes
  • High blood pressure
  • Smoking
  • Cancer

All health data was sourced from the Centers for Disease Control and Prevention and only cities with at least 200,000 people were included in the analysis. Here’s what the CBD Awareness Project found:

Takeaways

  • Many of the conditions that CBD has been reported to alleviate are closely related to each other, such as diabetes, high blood pressure, and smoking.
  • There is also a close relationship between mental health conditions like anxiety and depression and sleep disorders, which CBD has been shown to help with.
  • Geographically, the cities that would benefit most from CBD are primarily found in the Southeast and Midwestern regions of the US. Four cities in Ohio made the top 25, while two cities in Missouri, Louisiana, Alabama, and Tennessee, respectively made the list.
  • Only one city on the West Coast, where marijuana laws are the most relaxed, is featured below.

The 25 Cities That Would Benefit Most From CBD

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25. San Bernardino, CA

  • Adults with poor mental health: 16.1%
  • Adults sleeping less than 7 hours per night: 41.1%
  • Adults with arthritis: 23.1%
  • Adults with diabetes: 14.6%
  • Adults with high blood pressure: 35.0%
  • Adults who smoke: 18.9%
  • Adults with cancer: 5.2%
Photo Credit: Alamy Stock Photo

24. Richmond, VA

  • Adults with poor mental health: 13.4%
  • Adults sleeping less than 7 hours per night: 39.4%
  • Adults with arthritis: 24.8%
  • Adults with diabetes: 13.3%
  • Adults with high blood pressure: 36.8%
  • Adults who smoke: 20.5%
  • Adults with cancer: 5.7%
Photo Credit: Alamy Stock Photo

23. Pittsburgh, PA

  • Adults with poor mental health: 13.2%
  • Adults sleeping less than 7 hours per night: 40.4%
  • Adults with arthritis: 29.2%
  • Adults with diabetes: 10.4%
  • Adults with high blood pressure: 32.8%
  • Adults who smoke: 20.9%
  • Adults with cancer: 6.1%
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22. Lexington, KY

  • Adults with poor mental health: 12.9%
  • Adults sleeping less than 7 hours per night: 39.2%
  • Adults with arthritis: 27.4%
  • Adults with diabetes: 10.5%
  • Adults with high blood pressure: 34.9%
  • Adults who smoke: 20.2%
  • Adults with cancer: 6.3%
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21. Fayetteville, NC

  • Adults with poor mental health: 13.6%
  • Adults sleeping less than 7 hours per night: 38.5%
  • Adults with arthritis: 26.4%
  • Adults with diabetes: 12.4%
  • Adults with high blood pressure: 38.2%
  • Adults who smoke: 18.8%
  • Adults with cancer: 5.9%
Photo Credit: Alamy Stock Photo

20. New Orleans, LA

  • Adults with poor mental health: 13.1%
  • Adults sleeping less than 7 hours per night: 40.8%
  • Adults with arthritis: 25.4%
  • Adults with diabetes: 13.5%
  • Adults with high blood pressure: 39.3%
  • Adults who smoke: 20.5%
  • Adults with cancer: 5.6%
Photo Credit: Alamy Stock Photo

19. Kansas City, MO

  • Adults with poor mental health: 13.8%
  • Adults sleeping less than 7 hours per night: 38.2%
  • Adults with arthritis: 25.8%
  • Adults with diabetes: 11.7%
  • Adults with high blood pressure: 34.1%
  • Adults who smoke: 22.0%
  • Adults with cancer: 6.0%
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18. Baton Rouge, LA

  • Adults with poor mental health: 13.7%
  • Adults sleeping less than 7 hours per night: 38.6%
  • Adults with arthritis: 24.2%
  • Adults with diabetes: 13.8%
  • Adults with high blood pressure: 40.2%
  • Adults who smoke: 20.4%
  • Adults with cancer: 5.8%
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17. Nashville, TN

  • Adults with poor mental health: 13.4%
  • Adults sleeping less than 7 hours per night: 39.4%
  • Adults with arthritis: 26.8%
  • Adults with diabetes: 10.8%
  • Adults with high blood pressure: 35.2%
  • Adults who smoke: 21.5%
  • Adults with cancer: 6.1%
Photo Credit: Alamy Stock Photo

16. Columbus, OH

  • Adults with poor mental health: 14.1%
  • Adults sleeping less than 7 hours per night: 38.9%
  • Adults with arthritis: 26.0%
  • Adults with diabetes: 11.4%
  • Adults with high blood pressure: 33.9%
  • Adults who smoke: 22.2%
  • Adults with cancer: 6.2%
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15. Philadelphia, PA

  • Adults with poor mental health: 15.2%
  • Adults sleeping less than 7 hours per night: 42.6%
  • Adults with arthritis: 26.7%
  • Adults with diabetes: 12.7%
  • Adults with high blood pressure: 34.2%
  • Adults who smoke: 22.8%
  • Adults with cancer: 5.7%
Photo Credit: Alamy Stock Photo

14. Newark, NJ

  • Adults with poor mental health: 15.2%
  • Adults sleeping less than 7 hours per night: 48.9%
  • Adults with arthritis: 25.5%
  • Adults with diabetes: 15.3%
  • Adults with high blood pressure: 38.6%
  • Adults who smoke: 22.1%
  • Adults with cancer: 5.0%
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13. Milwaukee, WI

  • Adults with poor mental health: 14.9%
  • Adults sleeping less than 7 hours per night: 39.2%
  • Adults with arthritis: 26.0%
  • Adults with diabetes: 13.5%
  • Adults with high blood pressure: 37.5%
  • Adults who smoke: 22.2%
  • Adults with cancer: 5.8%
Photo Credit: Alamy Stock Photo

12. Baltimore, MD

  • Adults with poor mental health: 13.8%
  • Adults sleeping less than 7 hours per night: 43.2%
  • Adults with arthritis: 27.5%
  • Adults with diabetes: 13.7%
  • Adults with high blood pressure: 39.3%
  • Adults who smoke: 22.0%
  • Adults with cancer: 5.8%
Photo Credit: Alamy Stock Photo

11. Montgomery, AL

  • Adults with poor mental health: 14.3%
  • Adults sleeping less than 7 hours per night: 38.1%
  • Adults with arthritis: 29.8%
  • Adults with diabetes: 13.9%
  • Adults with high blood pressure: 40.8%
  • Adults who smoke: 21.1%
  • Adults with cancer: 6.0%
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10. Louisville, KY

  • Adults with poor mental health: 14.3%
  • Adults sleeping less than 7 hours per night: 38.0%
  • Adults with arthritis: 27.5%
  • Adults with diabetes: 11.0%
  • Adults with high blood pressure: 38.6%
  • Adults who smoke: 23.3%
  • Adults with cancer: 6.5%
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9. St. Louis, MO

  • Adults with poor mental health: 15.2%
  • Adults sleeping less than 7 hours per night: 37.7%
  • Adults with arthritis: 30.5%
  • Adults with diabetes: 14.0%
  • Adults with high blood pressure: 35.9%
  • Adults who smoke: 24.7%
  • Adults with cancer: 6.0%
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8. Memphis, TN

  • Adults with poor mental health: 15.6%
  • Adults sleeping less than 7 hours per night: 41.1%
  • Adults with arthritis: 29.8%
  • Adults with diabetes: 15.1%
  • Adults with high blood pressure: 43.0%
  • Adults who smoke: 24.5%
  • Adults with cancer: 5.5%
Photo Credit: Alamy Stock Photo

7. Birmingham, AL

  • Adults with poor mental health: 15.1%
  • Adults sleeping less than 7 hours per night: 41.8%
  • Adults with arthritis: 29.3%
  • Adults with diabetes: 16.7%
  • Adults with high blood pressure: 44.1%
  • Adults who smoke: 22.6%
  • Adults with cancer: 5.7%
Photo Credit: Alamy Stock Photo

6. Cincinnati, OH

  • Adults with poor mental health: 14.6%
  • Adults sleeping less than 7 hours per night: 42.9%
  • Adults with arthritis: 28.4%
  • Adults with diabetes: 13.9%
  • Adults with high blood pressure: 36.5%
  • Adults who smoke: 22.7%
  • Adults with cancer: 6.0%
Photo Credit: Alamy Stock Photo

5. Rochester, NY

  • Adults with poor mental health: 15.9%
  • Adults sleeping less than 7 hours per night: 39.7%
  • Adults with arthritis: 28.9%
  • Adults with diabetes: 13.7%
  • Adults with high blood pressure: 34.9%
  • Adults who smoke: 24.0%
  • Adults with cancer: 6.1%
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4. Cleveland, OH

  • Adults with poor mental health: 16.4%
  • Adults sleeping less than 7 hours per night: 42.6%
  • Adults with arthritis: 29.5%
  • Adults with diabetes: 15.8%
  • Adults with high blood pressure: 40.3%
  • Adults who smoke: 29.5%
  • Adults with cancer: 5.6%
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3. Toledo, OH

  • Adults with poor mental health: 15.8%
  • Adults sleeping less than 7 hours per night: 43.3%
  • Adults with arthritis: 31.1%
  • Adults with diabetes: 12.9%
  • Adults with high blood pressure: 36.0%
  • Adults who smoke: 26.7%
  • Adults with cancer: 6.1%
Photo Credit: Alamy Stock Photo

2. Buffalo, NY

  • Adults with poor mental health: 15.3%
  • Adults sleeping less than 7 hours per night: 42.7%
  • Adults with arthritis: 29.6%
  • Adults with diabetes: 13.9%
  • Adults with high blood pressure: 37.4%
  • Adults who smoke: 24.4%
  • Adults with cancer: 6.1%
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1. Detroit, MI

  • Adults with poor mental health: 17.9%
  • Adults sleeping less than 7 hours per night: 50.1%
  • Adults with arthritis: 33.3%
  • Adults with diabetes: 17.3%
  • Adults with high blood pressure: 46.3%
  • Adults who smoke: 28.6%
  • Adults with cancer: 5.8%

Methodology

The health data used in this analysis is from the Centers for Disease Control and Prevention 500 Cities Project, 2018 release. To identify cities that would benefit the most from CBD, a composite index was calculated based on the prevalence of conditions that CBD has been shown to help alleviate the symptoms of. These conditions include:

  • Poor mental health (including depression and anxiety)
  • Poor sleep habits
  • Arthritis
  • Diabetes
  • High blood pressure
  • Smoking
  • Cancer

All health data is for adults 18 years and over. Only cities with a population greater than or equal to 200,000 are included.