This study explores the role of stigma in cannabis use disclosure among patients in the U.S. healthcare system. It examines four domains of stigma: perceived, anticipated, enacted, and internalized. The study found that 57.1% of participants initiated conversations about cannabis use with their healthcare providers, while 27.8% of the time, cannabis use was never discussed. Healthcare providers initiated discussions only 15.1% of the time. Anticipated stigma and total stigma were significantly associated with nondisclosure. Factors such as annual household income, chronicity of cannabis use, frequency of use, and knowledge of CBD content were also significantly associated with disclosure frequency. Patients who use cannabis experience stigma in healthcare settings that may limit disclosure of their cannabis use history. Future studies should explore anticipated stigma more deeply. Healthcare providers should be knowledgeable to lead such conversations while maintaining an unbiased perspective. The study highlights the importance of comprehensive health assessments that include cannabis use history to ensure informed care. Stigma remains a significant barrier to effective treatment and care. The findings suggest that anticipated stigma is a critical factor in cannabis use disclosure. The study also emphasizes the need for education and training for healthcare providers to reduce stigma and improve patient care. The results indicate that cannabis use disclosure is influenced by various factors, including stigma, and that healthcare providers play a crucial role in facilitating open and honest discussions about cannabis use. The study underscores the importance of addressing stigma in healthcare settings to improve patient outcomes.This study explores the role of stigma in cannabis use disclosure among patients in the U.S. healthcare system. It examines four domains of stigma: perceived, anticipated, enacted, and internalized. The study found that 57.1% of participants initiated conversations about cannabis use with their healthcare providers, while 27.8% of the time, cannabis use was never discussed. Healthcare providers initiated discussions only 15.1% of the time. Anticipated stigma and total stigma were significantly associated with nondisclosure. Factors such as annual household income, chronicity of cannabis use, frequency of use, and knowledge of CBD content were also significantly associated with disclosure frequency. Patients who use cannabis experience stigma in healthcare settings that may limit disclosure of their cannabis use history. Future studies should explore anticipated stigma more deeply. Healthcare providers should be knowledgeable to lead such conversations while maintaining an unbiased perspective. The study highlights the importance of comprehensive health assessments that include cannabis use history to ensure informed care. Stigma remains a significant barrier to effective treatment and care. The findings suggest that anticipated stigma is a critical factor in cannabis use disclosure. The study also emphasizes the need for education and training for healthcare providers to reduce stigma and improve patient care. The results indicate that cannabis use disclosure is influenced by various factors, including stigma, and that healthcare providers play a crucial role in facilitating open and honest discussions about cannabis use. The study underscores the importance of addressing stigma in healthcare settings to improve patient outcomes.