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State Prevalence and Ranks of Adolescent Substance Use: Implications for Cancer Prevention

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Figure 1.
States’ simulated ranks for adolescent (aged 14–17 y) cigarette smoking as reported in the National Survey on Drug Use and Health (NSDUH) or Youth Risk Behavior Surveillance System (YRBSS), 2011–2015. YRBSS data were collected in 2011, 2013, and 2015; District of Columbia, Minnesota, Oregon, and Washington were excluded from YRBSS because they either chose not to participate or did not achieve adequate response rates. Past-month cigarette smoking was defined as smoking at least 1 cigarette in the previous 30 days. States are ordered by median rank in NSDUH across 100,000 simulations. Error bars indicate 95% confidence intervals.

State NSDUH
Rank (95% CI)
YRBSS
Rank (95% CI)
Wyoming 1 (1, 8) 4 (1, 9)
Montana 3 (1, 14) 18 (12, 25)
West Virginia 4 (1, 17) 2 (1, 5)
Kentucky 6 (1, 19) 2 (1, 6)
Missouri 6 (1, 20) 32 (21, 42)
South Dakota 6 (1, 21) 15 (5, 31)
Louisiana 8 (1, 26) 12 (4, 25)
Mississippi 10 (3, 27) 8 (3, 16)
Vermont 11 (3, 29) 32 (26, 38)
New Hampshire 12 (3, 30) 20 (11, 30)
Arkansas 13 (3, 34) 7 (2, 15)
New Mexico 13 (3, 36) 14 (9, 22)
North Dakota 13 (3, 32) 11 (6, 19)
Oklahoma 13 (3, 31) 7 (2, 15)
South Carolina 14 (4, 32) 17 (9, 28)
Wisconsin 16 (4, 37) 29 (20, 38)
Iowa 19 (7, 34) 6 (1, 20)
Colorado 20 (6, 40) 14 (4, 31)
Pennsylvania 20 (11, 32) 32 (17, 43)
Delaware 21 (7, 40) 27 (19, 34)
Ohio 21 (12, 32) 6 (1, 19)
Idaho 22 (8, 39) 36 (28, 42)
Washington State 23 (7, 43)
Indiana 24 (9, 41) 20 (10, 32)
Tennessee 24 (9, 40) 11 (6, 19)
Maine 25 (9, 42) 30 (25, 35)
Michigan 25 (14, 36) 35 (27, 42)
Georgia 26 (11, 41) 18 (9, 29)
Alaska 29 (12, 44) 36 (26, 43)
Minnesota 30 (14, 44)
Hawaii 31 (14, 45) 42 (38, 44)
Kansas 31 (12, 47) 31 (22, 39)
Oregon 31 (14, 46)
Nebraska 32 (15, 46) 25 (17, 33)
North Carolina 33 (16, 46) 17 (10, 25)
Massachusetts 34 (18, 47) 40 (34, 43)
Alabama 35 (20, 46) 5 (2, 12)
Nevada 37 (21, 49) 44 (43, 46)
New Jersey 37 (23, 47) 24 (13, 35)
Illinois 38 (30, 45) 26 (18, 35)
Connecticut 42 (26, 50) 26 (18, 36)
Rhode Island 42 (25, 50) 45 (43, 46)
Arizona 43 (31, 50) 27 (18, 36)
Maryland 43 (29, 50) 40 (34, 43)
Virginia 43 (31, 50) 38 (29, 43)
Washington DC 44 (30, 51)
Texas 44 (36, 49) 17 (10, 25)
New York 46 (41, 50) 41 (36, 43)
Florida 48 (43, 50) 37 (33, 41)
California 49 (45, 51) 46 (43, 47)
Utah 51 (47, 51) 47 (46, 47)

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Figure 2.
States’ simulated ranks for adolescent (aged 14–17 y) alcohol consumption as reported in the National Survey on Drug Use and Health (NSDUH) or Youth Risk Behavior Surveillance System (YRBSS), 2011–2015. YRBSS data were collected in 2011, 2013, and 2015; District of Columbia, Minnesota, Oregon, and Washington were excluded from YRBSS because they either chose not to participate or did not achieve adequate response rates. Past-month binge drinking was defined as consuming 5 or more alcoholic drinks per drinking occasion on at least 1 of the previous 30 days. NSDUH data on binge alcohol drinking came from survey years 2011–2014 only. States are ordered by median rank in NSDUH across 100,000 simulations. Error bars indicate 95% confidence intervals.

State NSDUH Rank (95% CI) YRBSS Rank (95% CI)
New Jersey 1 (1, 8) 5 (1, 16)
Vermont 2 (1, 13) 22 (16, 28)
Massachusetts 5 (1, 20) 18 (10, 28)
Oregon 6 (1, 24)
New Hampshire 7 (2, 25) 18 (10, 29)
New York 8 (3, 18) 21 (10, 32)
Montana 9 (2, 32) 2 (1, 6)
South Dakota 9 (2, 36) 26 (12, 37)
West Virginia 9 (2, 31) 9 (4, 16)
Louisiana 12 (2, 38) 6 (1, 19)
Wyoming 12 (2, 36) 5 (1, 10)
Hawaii 15 (3, 38) 43 (38, 46)
Kansas 16 (3, 43) 24 (13, 34)
Maryland 17 (4, 41) 35 (28, 40)
Pennsylvania 17 (8, 31) 43 (33, 46)
Missouri 18 (4, 44) 7 (2, 17)
Arkansas 19 (4, 45) 15 (7, 27)
Colorado 20 (5, 44) 5 (1, 21)
Connecticut 21 (5, 47) 24 (13, 34)
Michigan 21 (10, 37) 38 (31, 43)
Alabama 22 (7, 45) 27 (15, 36)
Iowa 22 (7, 44) 3 (1, 26)
Idaho 23 (6, 46) 23 (11, 34)
California 25 (14, 37) 40 (21, 46)
New Mexico 25 (5, 48) 22 (13, 30)
Washington State 25 (7, 47)
Ohio 27 (15, 40) 16 (5, 33)
Wisconsin 28 (8, 48) 12 (5, 25)
Rhode Island 29 (8, 49) 38 (30, 45)
Nevada 30 (7, 50) 31 (19, 40)
Georgia 33 (13, 48) 37 (28, 45)
Maine 34 (13, 49) 44 (41, 46)
Nebraska 34 (12, 49) 38 (31, 45)
Florida 35 (22, 45) 33 (28, 38)
Illinois 35 (21, 45) 20 (11, 31)
North Carolina 35 (13, 49) 39 (33, 44)
North Dakota 35 (12, 50) 11 (5, 20)
Texas 35 (22, 45) 5 (1, 12)
Mississippi 36 (13, 50) 30 (19, 39)
Washington, DC 37 (11, 51)
Indiana 37 (15, 50) 27 (12, 37)
Oklahoma 38 (16, 50) 15 (7, 28)
South Carolina 38 (15, 50) 34 (23, 42)
Arizona 40 (19, 50) 10 (3, 23)
Virginia 40 (20, 50) 44 (38, 46)
Delaware 41 (17, 51) 23 (14, 31)
Minnesota 45 (26, 51)
Kentucky 46 (28, 51) 13 (6, 24)
Alaska 47 (28, 51) 43 (37, 46)
Tennessee 47 (32, 51) 30 (19, 38)
Utah 50 (40, 51) 47 (47, 47)

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Figure 3.
States’ simulated ranks for adolescent (aged 14–17 y) marijuana use as reported in the National Survey on Drug Use and Health (NSDUH) or Youth Risk Behavior Surveillance System (YRBSS), 2011–2015. Past-month marijuana use was defined as using marijuana at least once in the previous 30 days. YRBSS data were collected in 2011, 2013, and 2015; District of Columbia, Minnesota, Oregon, and Washington were excluded from YRBSS because they either chose not to participate or did not achieve adequate response rates. Data on marijuana use in YRBSS were not available for Hawaii. States are ordered by median rank in NSDUH across 100,000 simulations. Error bars indicate 95% confidence intervals.

State NSDUH Rank (95% CI) YRBSS Rank (95% CI)
Rhode Island 1 (1, 4) 5 (2, 10)
Colorado 2 (1, 8) 11 (4, 22)
Vermont 3 (1, 7) 8 (3, 12)
Washington, DC 5 (2, 13)
Washington State 5 (2, 17)
Massachusetts 7 (3, 17) 2 (1, 6)
New Hampshire 7 (3, 16) 5 (2, 10)
Oregon 8 (3, 20)
Maine 11 (4, 23) 18 (13, 24)
Alaska 13 (5, 27) 23 (13, 32)
Michigan 13 (7, 20) 31 (24, 38)
Montana 13 (5, 26) 17 (11, 25)
Nevada 13 (5, 25) 24 (12, 37)
New Mexico 13 (5, 26) 1 (1, 2)
Hawaii 14 (6, 26)
Connecticut 15 (6, 28) 8 (3, 13)
Maryland 17 (7, 30) 18 (12, 25)
Wisconsin 17 (7, 29) 29 (16, 40)
Arizona 18 (8, 29) 8 (2, 16)
New York 18 (11, 25) 22 (14, 29)
California 19 (13, 25) 10 (2, 30)
Delaware 20 (9, 35) 4 (2, 9)
Indiana 24 (14, 39) 32 (23, 40)
Pennsylvania 24 (17, 33) 34 (22, 42)
Georgia 25 (14, 42) 19 (10, 30)
Missouri 29 (18, 44) 32 (21, 41)
Florida 30 (23, 38) 13 (10, 19)
Idaho 30 (17, 46) 37 (28, 42)
Illinois 30 (23, 39) 14 (9, 24)
Texas 30 (23, 40) 19 (11, 27)
New Jersey 32 (20, 46) 23(12, 33)
Ohio 33 (25, 41) 15 (6, 29)
North Carolina 34 (20, 48) 8 (3, 13)
Arkansas 35 (20, 49) 36 (28, 42)
South Carolina 36 (23, 48) 18 (10, 28)
Kansas 37 (23, 50) 41 (34, 44)
Wyoming 37 (22, 49) 26 (18, 34)
Minnesota 38 (24, 49)
South Dakota 39 (24, 50) 43 (33, 45)
North Dakota 41 (26, 50) 42 (39, 44)
Oklahoma 41 (24, 51) 35 (24, 42)
Alabama 43 (29, 51) 33 (23, 41)
Kentucky 43 (26, 51) 35 (25, 41)
Tennessee 43 (30, 50) 16 (10, 26)
Virginia 43 (28, 51) 36 (28, 41)
West Virginia 43 (30, 50) 30 (21, 39)
Iowa 44 (30, 51) 43 (30, 45)
Nebraska 44 (31, 51) 45 (43, 45)
Mississippi 46 (33, 51) 31 (23, 39)
Louisiana 50 (40, 51) 37 (24, 43)
Utah 50 (33, 51) 46 (46, 46)

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Page last reviewed: May 31, 2018