Midterms 2018: The states considering legalising marijuana on election day

North Dakota, Michigan, Missouri and Utah all proposing revisions to laws

American voters heading to the polls for the midterm elections will be deciding on more than just their pick of lawmakers at the ballot box on Tuesday.

In addition to choosing senators and state governors – and therein determining whether the Republicans or Democrats hold a controlling majority in the Senate and House of Representatives – the electorate are also voting on crucial matters of policy at a state level.

In Idaho, Utah and Nebraska, for instance, voters will decide whether to extend Medicaid. In West Virginia, Oregon and Alabama, access to abortion will be under the microscope.

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The legalisation of marijuana is also up for debate, one of the most divisive topics in the current American political landscape.

Despite cannabis being the subject of a federal prohibition, nine states and the District of Columbia all now permit its recreational use while 30 allow its administering on medical grounds.

On Tuesday, North Dakota and Michigan will decide whether to permit recreational use while Missouri and Utah will ask voters whether the drug should play a role in healthcare.

In North Dakota, Measure 3 sets a minimum purchase age of 21, erases pot convictions from criminal records and adds new penalties for those found selling it to minors.

In Michigan, Proposal 1 sets an age limit of 21, compels the state to establish a licensing system for growers and sellers, allows local businesses to prohibit its consumption on their premises and places a 10 per cent sales tax on cannabis.

In Missouri, the new proposal would change the state's constitution to make it harder to change marijuana laws in future and similarly prompt the state to build a regulatory system.

In Utah, Proposition 2 will make it legal for sufferers to access pot but not in a smokable or edible form or to grow their own supply at home.

The increasing liberalisation of attitudes towards marijuana, typically in left-leaning states, is grounded in research suggesting it can be used to soothe a range of ailments and complaints, from chronic muscle pain or nausea during cancer treatment to relieving the symptoms of glaucoma, Crohn’s disease, Parkinson’s, multiple sclerosis and childhood epilepsy.

Democrat Beto O’Rourke, running against Ted Cruz for the Texas Senate, is one of the most high-profile liberal candidates to have called for decriminalisation during the current campaign season.

An unofficial lobbying day known as “420” – started by a group of Grateful Dead fans in California in the 1970s – takes place on 20 April every year to call for the wider acceptance of weed.

Arkansas, California, Florida, Massachusetts, Nevada and North Dakota all increased access to marijuana in 2016, a watershed year for the issue.

Internationally, Uruguay became the first country in the world to completely legalise recreational marijuana in 2017 but Canada recently voted to follow suit, prompting speculation that other western nations could do the same.