Voters in 53 counties and 53 cities in Kentucky voted Tuesday on a ballot referendum asking if medical cannabis businesses should be allowed to operate there — and every last one of the jurisdictions voted yes.

None of the 106 ballot referendums failed, meaning the large majority of local governments in Kentucky will not prohibit businesses licensed by the state under its new medical marijuana program, which launches Jan. 1.

Just 20 counties have passed local ordinances to ban such businesses, though many of these include cities that will allow them, either through their own local ordinances or the ballot referendum Tuesday. More than 40 cities have also passed ordinances to ban them.

Kentucky is awarding most of the medical cannabis business licenses before the end of this year through a lottery system. Last month it selected all 16 businesses that will receive a cultivator license and 10 that will receive a processor license. Nearly 50 dispensary licenses will be awarded in two lottery drawings in November and December.

Of the 53 counties that voted on the cannabis referendum, 67% of them — collectively, 341,766 people — voted to approve such businesses in the county. A nearly identical percentage of voters in the 53 cities also voted to green light the businesses.

The two counties that voted in favor of such businesses by the largest margins were Marion and Nelson counties, where more than 75% voted yes. Coincidentally or not, these were two of the three counties where the so-called “Cornbread Mafia” operated in Kentucky in the 1970s and 1980s, which federal prosecutors called the largest domestic marijuana syndicate in American history.

The smallest margin of victory for the medical marijuana referendum was in Hickman County, with 54% of voters in the far west Kentucky county voting yes.

Voters of Bardstown provided the largest margin of victory among Kentucky cities who voted on the measure, where it passed with 78% of the vote.

The cities with the highest population to pass the measure were Shelbyville in Shelby County (72%), Mt. Washington in Bullitt County (67%), Florence in Boone County (64%) and Independence in Kenton County (63%).

The closest a ballot measure came to failing was in Union, the Boone County city where 52% of voters approved cannabis businesses to operate there.

Voters in several cities voted both on a city referendum and on a county referendum, such as Manchester in Clay County, which approved both.

Manchester is the home of Republican Senate President Robert Stivers, who put up arguably the strongest opposition to legalizing medical cannabis in Frankfort for many sessions of the Kentucky General Assembly, until it became law in 2023.

Voters in Manchester approved the cannabis measure with 69% of the vote, while 68% of Clay County voters approved allowing the businesses.

Even in the minority of local jurisdictions choosing to prohibit medical cannabis businesses through ordinances, eligible patients will still be allowed to possess and use prescribed marijuana in those cities and counties.

State government and politics reporting is supported in part by the Corporation for Public Broadcasting.