Campanella, who originally hails from New Jersey but now lives in Los Angeles, will represent the United States at this year's Miss Universe pageant in September in Brazil.
Auburn-haired Campanella, 21, took the stage donning both a turquoise gown and a blue and white polka dot bikini for the event's evening gown and swimsuit portions, and she answered a question regarding the legalization of marijuana for the Q&A section of the competition.
"I understand why that question would be asked, especially with today's economy, but I also understand that medical marijuana is very important to help those who need it medically," Campanella said.
"I'm not sure if it should be legalized, if it would really affect, with the drug war. I mean, it's abused today, unfortunately, so that's the only reason why I would kind of be a little bit against it, but medically it's OK."
Ashley Durham, Miss Tennessee, was the first runner-up in Sunday night's competition. Contestants from Alabama and Texas placed third and fourth.
Kia Ben-et Hampton, Miss Kentucky, won Miss Congeniality USA, while Miss Arizona Brittany Dawn Brannon won Miss Photogenic USA.
The competition had a different tone than those of years past. Though it's been two years since Miss USA runner-up Carrie Prejean fell from grace, many contenders were wary of making the same missteps in the question-and-answer portion of the competition that she did.
Prejean spoke out against gay marriage at the 2009 competition and was later stripped of her Miss California USA crown for alleged breaches of contract.
"The girls are scared to death," Keith Lewis, the director of state pageants for California, New York and New Hampshire, told Fox News last week. "They witnessed with Carrie Prejean how a firestorm can create a road kill, and nobody wants to be part of a situation like that again."
One contestant made headlines well before Sunday night. In February, Blair Griffith revealed that she was homeless months after being named Miss Colorado USA. The 23-year-old beauty queen and her mother were evicted just weeks after her October 2010 victory.
"The only thing I had time to grab was my crown and my sash," Griffith told ABC News' "20/20."
After telling the directors of the Miss USA pageant that she had lost her home, Griffith made the decision to go public with her story. She has spent much of the past year traveling the country speaking about her experience.
"What I've learned is that there are so many in this country, especially families with children, who are unseen, who are doubled up in the homes of friends and family, who are homeless because they don't have a home of their own to go to," she said.
Meanwhile, outgoing Miss USA Rima Fakih spent the days prior to giving up her crown partying.
"I'm only human," Fakih, 25, told the New York Post after club-hopping in Las Vegas.
She almost lost her crown earlier this year after going out late and sleeping through an interview.
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