Cape Girardeau County voters approved the referendum by a 57.6% to 42.4% vote with 61.1% of those registered casting ballots.
The group Legal Missouri 2022 now hopes to place a recreational cannabis measure on the ballot.
John Payne, campaign manager for Missouri 2022, noting the booming sales of medical marijuana in the Show Me State -- $186 million since October 2020 -- said last week it is now time for the state's voters to OK "adult use" of cannabis.
"The status quo continues to feed illicit markets and distracts law enforcement from more serious property and violent crimes," Payne said Thursday, as Legal Missouri 2022 launched a signature collection campaign aimed at getting a plebiscite authorized next year.
Payne said 19 U.S. states have expanded marijuana legalization beyond medical needs.
Legal Missouri, which said it has already spent $280,000 gearing up for its election campaign, said it will need 170,000 Missourians to sign petitions to get on the ballot in November.
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