Voters in Michigan, Utah, and Missouri all approved their cannabis ballot measures after the midterm elections Nov. 6, 2018.

Michigan legalized cannabis for adult use, becoming the first state in the Midwest to approve of legalized cannabis. Medical initiatives were also passed by voters in Utah in Missouri.

In total, 10 states have legalized cannabis for adult use and 33 states allow for medical use.

Tuesday’s election results confirm what many believe to be a sweeping change in cannabis attitudes across different regions of the country, while cannabis remains illegal at the federal level.

“I think it’s safe to say federal laws are in need of an update,” Steve Hawkins, executive director of the Marijuana Policy Project, said in a statement. “We hope the results of this election will inspire Congress to finally start addressing the tension that exists between state and federal marijuana laws in our nation.”

In Michigan, adults 21 and older will be allowed to purchase flower, concentrates, and edibles, as well as grow up to 12 plants at home. Adults will also be allowed to possess 10 ounces of flower. A 10% cannabis tax imposed on retail sales will go toward regulating the legal program, clinical research, schools, roads, and local municipalities. The adult use measure was approved by nearly 57% of voters.

In Utah, residents with qualifying medical conditions such as cancer, HIV, epilepsy, chronic pain, ALS, Alzheimer’s, Crohn’s disease, Multiple Sclerosis, PTSD, and autism will be able to use medical cannabis. Some patients may also be approved to grow up to six plants for personal medical uses. The medical ballot initiative was approved by 53% of voters.

In Missouri, the medical Amendment will legalize, tax, and regulate cannabis for medical uses. Medical cannabis will be taxed at 4 percent, with revenues going toward health care services for military veterans and administering the state’s cannabis program. Patients will be allowed to cultivate at home. Measure 2 was approved by 65% of voters.