The states and countries most addicted to smoking and alcohol
Around 21 million Americans have at least one addiction, ranging from smoking and excessive drinking to vaping and drugs. Even some prescription drugs can cause addictions if misused. These addictions are responsible for thousands of deaths every year, and only around 10% of people receive the treatment they need.
With that said, our experts at Universal Drugstore have analyzed statistics to reveal how the US compares to other countries, and which US states have the highest rates of addiction. Looking at drug addiction, excessive alcohol consumption, and smoking.
Most addicted states in the US
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Colorado
Addiction Score: 6.95/10
Colorado comes out as the state with the most people affected by addiction, scoring 6.95/10. Colorado has the highest rate of vaping addiction in the US, with 7.5% of residents being addicted. It also ranked fifth for illicit drug use, with more than a fifth of the population affected. It ranked joint-twelfth for excessive drinking and tied for 38th for smoking rates.
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Montana
Addiction Score: 6.90/10
In second place, we have Montana, with a score of 6.9/10 for having the most people affected by addictions. Montana ranked in the top 15 for smoking rates, illicit drug use and excessive alcohol consumption, the latter of which they ranked third, with 24% of the population drinking alcohol excessively.
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Alaska
Addiction Score: 6.80/10
Rounding out the top three, we have Alaska, scoring 6.8/10. Alaska ranked third for illicit drug use rates, with 22.9% of the population using drugs. It also ranked in the top 15 for smoking rates and excessive alcohol consumption. For vaping, Alaska ranked 28th, with a 5% use rate for its population.
Top 3 US states with the most smokers
![Top 3 US states with the most smokers Top 3 US states with the most smokers](https://www.universaldrugstore.com/media/wysiwyg/_Universal_Drugstore_Addicted_States__05_Highest_proportion_of_smokers_1.jpg)
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West Virginia
Percentage of Adult Smokers: 24%
West Virginia has the highest percentage of adult smokers among US states, with a quarter (24%) of its adult population having this habitual addiction. This is much higher than the national smoking rate for the US, of just 11.5% estimated by the CDC in 2021.
Top 3 US states with the most excessive drinkers
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Wisconsin
Percentage of Excessive Drinkers: 26%
The state with the highest percentage of excessive drinkers is Wisconsin, with 26% of its population drinking alcohol excessively on a regular basis. In 2021, 41 out of 50 of the most heavily drinking counties in the US were located in Wisconsin, further highlighting how alcohol affects residents of the state.
Top 3 US states with the most illicit drug users
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Vermont
Percentage of Illicit Drug Users: 24.9%
Vermont is the US state with the highest percentage of illicit drug users, at 24.9%. Vermont has one of the highest substance abuse rates in the US, including higher cannabis and heroin use for people aged between 18 and 25.
Top 3 US states with the most vape users
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Colorado
Percentage of E-Cigarette Users: 7.5%
The state with the highest number of vapers is Colorado, which has already ranked as the state with the highest number of people affected by addictions. As of 2023, 7.5% of adults in Colorado use e-cigarettes.
Most addicted countries in the world
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Latvia
Percentage of E-Cigarette Users: 7.5%
The country with the most people affected by addictions is Latvia, having scored 8.71/10. Latvia ranked top for the most alcohol consumed per capita, at 12.2 liters. It also ranked in the top ten for having the highest proportion of smokers aged 15 years and over, at 22.6%, and for the proportion of people with drug disorders, at 1.2%.
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Estonia
Percentage of E-Cigarette Users: 7.5%
Estonia comes in second place for countries most affected by addiction, with a score of 7.8/10. Estonia came in the top 20 for the proportion of daily smokers over the age of 15, with 17.9%. Estonia also came joint-fifth for the alcohol consumed per capita at 11.1 liters and the proportion of the population with drug use disorders, at 1.6%.
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Austria
Addiction Score: 7.65
Third, we have Austria, with a score of 7.65 for the number of people affected by addictions. Austria has a per capita alcohol consumption of 11.1 liters, putting them joint-fifth with Estonia. Additionally, 20.6% of the population aged 15 and over are daily smokers, which puts Austria 12th in that ranking. The country also placed joint-tenth for the proportion of the population with drug use disorders at 1.1%.
Top 3 countries where drug disorders are most prevalent
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United States
Percentage of Population with Drug Disorders: 3.40%
The United States is the country where drug disorders are the most prevalent, with around 3.4% of the population affected. As of 2020, around 37 million Americans aged 12 or older were illegal drug users, highlighting the ongoing issues with drug addiction in the US.
Top 3 countries with the most smokers
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Indonesia
Percentage of Smokers (over 15 years old): 32.6%
Indonesia comes out as the country with the highest proportion of smokers, with 32.6% of the population doing so daily. The majority of these smokers use clove-flavored kreteks, the manufacturers of which directly employ around 180,000 people in Indonesia and a further 10 million indirectly. Despite high levels of smokers, Indonesia is a religious country where many residents abstain from drinking alcohol.
Top 3 countries with the most excessive drinkers
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Latvia
Liters of Alcohol Consumed per Capita: 12.2
Lativa, which ranked top overall, also ranks top among countries for the most alcohol consumed per capita, at 12.2 liters annually. This is roughly the equivalent of 2.6 bottles of wine or 4.9 liters of beer weekly. Men also consume much more alcohol in Latvia, at 20.9 liters per capita yearly, compared to women who consume 6.1 liters.
Tips on how to get help with addictions
There are many ways for you to get the help you need if you are suffering from addiction or substance abuse, such as the free resources outlined on the American Addiction Centers site. On the site, you can find a range of 24/7 hotlines that can refer you to treatment facilities and support groups or community-based services. This way, you can have a support system to help you recover properly.
There are also a range of pharmaceutical aids for a range of addictions. For example, nicotine patches can be used by those trying to quit smoking. There are also a range of medications to aid in withdrawal symptoms, such as naltrexone and buprenorphine. These medications can also aid in reducing the intensity of cravings, especially where recovering opioid users are concerned.
Methodology -
We wanted to show which states were most affected by common addictive substances. As such, we used Country Health Rankings to get the percentage of adult smokers and excessive drinkers for each US state for 2023.
We then used the Substance Abuse and Mental Health Services Administration’s “2021 NSDUH: Model-Based Estimated Prevalence For States” to get the percentage of illicit drug users for each state in the US for 2021.
Using the National Library of Medicine’s “Assessment of Patterns in e-Cigarette Use Among Adults in the US, 2017-2020” to get the percentage of e-cigarette users for each state, taking the most recently available figure.
We then ranked each state based on these four factors to give them a normalized score out of 10, to determine which states were most affected by addiction.
We also wanted to show which countries were most affected by addiction. Using the OECD’s “Daily smokers” to get the percentage of each country's population that smoked daily, taking the most recently available figure.
Using the OECD’s “Alcohol consumption,” we then took the number of liters of alcohol consumed per capita annually for each country. Again, we used the most recently available figure for each country.
We then used Our World in Data’s “Opioids, cocaine, cannabis and other illicit drugs” to get the percentage of each country’s population that suffered from drug use disorders for 2019.
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