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Banner image for The NSDUH (National Survey on Drug Use and Health) Report
Issue 13 2006

State Estimates of Underage Drinking

In Brief
  • In 2003-2004, past month alcohol use rates for persons aged 12 to 20 were among the lowest in Utah (18.6 percent) and Tennessee (22.3 percent) and among the highest in North Dakota (42.7 percent) and South Dakota (39.1 percent)


  • Between 2002-2003 and 2003-2004, past month alcohol use increased in California (from 24.7 to 26.3 percent) and Wisconsin (from 34.7 to 38.3 percent), while binge alcohol use increased in Iowa (from 24.7 to 27.7 percent) and Oklahoma (from 19.1 to 21.5 percent)


  • Past month alcohol use decreased between 2002-2003 and 2003-2004 in South Carolina (from 27.2 to 24.1 percent) and Michigan (from 31.8 to 30.2 percent), while binge alcohol use decreased in South Carolina and North Carolina (both from 18.0 to 15.9 percent) and in Tennessee (from 15.9 to 13.1 percent)

Underage drinking is known to vary across States.1 The National Survey on Drug Use and Health (NSDUH) asks respondents aged 12 or older to report on their alcohol and binge alcohol use in the past 30 days. NSDUH defines binge alcohol use as drinking five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days.

This report presents State estimates of past month and binge alcohol use among persons aged 12 to 20. Estimates are based on a small area estimation (SAE) methodology in which State-level NSDUH data are combined with local-area county and census block group/tract-level data from the State. This model-based methodology provides more precise estimates of substance use at the State level than those based solely on the sample, particularly for smaller States.

State Estimates of Past Month Alcohol Use

In 2003-2004, 28.8 percent of persons aged 12 to 20 drank alcohol in the past month. Rates of past month alcohol use were among the lowest in Utah (18.6 percent) and Tennessee (22.3 percent) and among the highest in North Dakota (42.7 percent) and South Dakota (39.1 percent).

Figure 1 shows State differences in the rate of past month alcohol use among persons 12 to 20 years old. States with the highest estimates fall into the top quintile (fifth) and are shown in red. States with the lowest estimates are in the bottom quintile and are shown in blue. Of the 10 States with the highest rates of past month alcohol use, half are in the Midwest (Iowa, Nebraska, North Dakota, South Dakota, and Wisconsin).2 Of the 10 States with the lowest rates of past month alcohol use, 8 are in the South (Alabama, Arkansas, Georgia, Mississippi, North Carolina, South Carolina, Tennessee, and Texas).

Figure 1. Percentages of Persons Aged 12 to 20 Reporting Past Month Alcohol Use, by State: 2003 and 2004
United States Map comparing percent of persons aged 12 to 20 reporting past month alcohol use, by State between 2003 and 2004. Accessible table located below this figure.

Figure 1 Table. Percentages of Persons Aged 12 to 20 Reporting Past Month Alcohol Use, by State: 2003 and 2004
State Aged 12-20
North Dakota 42.68
South Dakota 39.12
Wisconsin 38.25
Montana 38.10
New Hampshire 37.30
Rhode Island 36.20
Iowa 35.60
Connecticut 34.72
Massachusetts 34.51
Nebraska 33.98
Colorado 33.67
Vermont 33.35
Missouri 33.20
Wyoming 32.83
Minnesota 32.57
Kansas 32.19
New York 31.99
Washington 31.31
New Mexico 31.26
Delaware 31.00
Oregon 30.86
Pennsylvania 30.77
Illinois 30.35
District of Columbia 30.18
Michigan 30.17
Oklahoma 30.15
Kentucky 30.02
Louisiana 29.97
Ohio 29.75
Virginia 29.14
Maine 28.78
New Jersey 28.08
Idaho 27.85
Arizona 27.46
Florida 27.32
West Virginia 27.09
Maryland 27.07
Hawaii 26.75
Indiana 26.74
California 26.30
Alaska 26.29
Texas 26.10
Arkansas 25.92
Alabama 25.90
North Carolina 25.07
Nevada 24.47
Georgia 24.20
South Carolina 24.13
Mississippi 23.12
Tennessee 22.32
Utah 18.63

State Estimates of Binge Alcohol Use

In 2003-2004, 19.4 percent of persons aged 12 to 20 engaged in binge alcohol use in the past month. As with any past month use, the rates of binge use were among the lowest in Tennessee (13.1 percent) and Utah (14.5 percent) and among the highest in North Dakota (32.3 percent) and South Dakota (29.5 percent) (Figure 2). All but two of the States in the top quintile were either in the Midwest or Northeast, and all but two of the States in the bottom quintile (Utah and Nevada) were in the South.

Figure 2. Percentages of Persons Aged 12 to 20 Reporting Past Month Binge Alcohol Use, by State: 2003 and 2004
United States Map comparing percent of persons aged 12 to 20 reporting past month binge alcohol use, by State between 2003 and 2004. Accessible table located below this figure.

Figure 2 Table. Percentages of Persons Aged 12 to 20 Reporting Past Month Binge Alcohol Use, by State: 2003 and 2004
State Aged 12-20
North Dakota 32.29
South Dakota 29.49
Montana 28.98
Iowa 27.67
Wisconsin 26.48
New Hampshire 26.18
Rhode Island 25.78
Massachusetts 24.31
Wyoming 24.15
Kansas 24.11
Vermont 24.05
Nebraska 23.75
Minnesota 23.38
Missouri 23.02
Connecticut 22.80
New Mexico 21.73
Illinois 21.65
Pennsylvania 21.61
Oklahoma 21.52
Washington 21.49
New York 21.16
Ohio 20.89
Colorado 20.85
Oregon 20.71
Maine 20.49
Michigan 20.48
Virginia 20.26
Delaware 20.21
West Virginia 20.09
Idaho 19.94
Kentucky 19.71
Arizona 19.64
Hawaii 19.53
Alaska 19.04
Louisiana 18.69
Indiana 18.60
Arkansas 17.97
Florida 17.48
New Jersey 17.47
Alabama 17.16
California 16.91
Texas 16.69
District of Columbia 16.51
Nevada 16.50
Maryland 16.24
North Carolina 15.88
South Carolina 15.86
Mississippi 15.67
Georgia 15.38
Utah 14.50
Tennessee 13.12

State Trends in Underage Drinking

In most States, rates of past month and binge alcohol use have remained relatively stable over the past few years. However, a handful of States have seen significant changes. Between 2002-2003 and 2003-2004, rates of past month alcohol use increased in California (from 24.7 to 26.3 percent) and Wisconsin (from 34.7 to 38.3 percent).3 Rates of binge alcohol use increased in Iowa (from 24.7 to 27.7 percent) and Oklahoma (from 19.1 to 21.5 percent). Conversely, rates of past month alcohol use decreased in South Carolina (from 27.2 to 24.1 percent) and Michigan (from 31.8 to 30.2 percent). Rates of binge alcohol use decreased in South Carolina and North Carolina (both from 18.0 to 15.9 percent) and in Tennessee (from 15.9 to 13.1 percent).

End Notes
1 Wright, D., & Sathe, N. (2006). State estimates of substance use from the 2003-2004 National Surveys on Drug Use and Health (DHHS Publication No. SMA 05-4063, NSDUH Series H-29). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.
2 The West has 13 States: AK, AZ, CA, CO, HI, ID, MT, NM, NV, OR, UT, WA, and WY. The South has 16 States plus the District of Columbia: AL, AR, DE, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, and WV. The Northeast has 9 States: CT, MA, ME, NH, NJ, NY, PA, RI, and VT. The Midwest has 12 States: IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, and WI.
3 The precision of the SAE estimates, particularly for States with smaller sample sizes, can be improved significantly by combining data across 2 years (i.e., 2002 to 2003 and 2003 to 2004). For more information, see the report cited in footnote 1, which also is available online at http://www.oas.samhsa.gov/states.htm and http://www.oas.samhsa.gov/states.htm#Prevalence.

Figure Note
Source: SAMHSA, 2002, 2003, and 2004 NSDUHs.

The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). Prior to 2002, this survey was called the National Household Survey on Drug Abuse (NHSDA). The 2003-2004 data used in this report are based on information obtained from 62,710 persons aged 12 to 20; the 2002-2003 data are based on information from 64,262 persons aged 12 to 20. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)

Information on NSDUH used in compiling data for this issue is available in the following publications:

Office of Applied Studies. (2005). Results from the 2004 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 05-4062, NSDUH Series H-28). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Office of Applied Studies. (2004). Results from the 2003 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 04-3964, NSDUH Series H-25). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Office of Applied Studies. (2003). Results from the 2002 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 03-3836, NSDUH Series H-22). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Also available online: http://www.oas.samhsa.gov

Because of improvements and modifications to the 2002 NSDUH, estimates from the 2002, 2003, and 2004 surveys should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time.

The NSDUH Report (formerly The NHSDA Report) is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://www.oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov.

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This page was last updated on December 30, 2008.

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