41. South Dakota
> Drunkest city: Sioux Falls
> Pct of MSA adults binge or heavy drinking: 21.1%
> Pct. of state adults binge or heavy drinking: 19.4%
> Pct of driving deaths alcohol related: 32.7%

The average South Dakota resident consumes around 38 gallons of beer each year, more than in all but three other states, according to a recent study from beer industry data company Beer Insights. The percentage of adults in the state reporting binge or heavy drinking of 19.4% is also one of the highest proportions compared to other states. In Sioux Falls, the metro area with the highest level of excessive drinking, 21.1% of adults report a heavy or binge drinking habit.

42. Tennessee
> Drunkest city: Clarksville
> Pct of MSA adults binge or heavy drinking: 16.8%
> Pct. of state adults binge or heavy drinking: 9.3%
> Pct of driving deaths alcohol related: 27.6%

Most Tennessee city residents drink less than Americans in the rest of the country, and the state as a whole ties Utah as the driest nationwide. Clarksville, however, is an exception. Almost 17% of Clarksville residents report heavy or binge drinking over a 30-day period, slightly higher than the national figure and considerably higher than across Tennessee. Despite the excessive drinking, Clarksville’s health outcomes are on par with statewide levels. In both the city and the state, about 19% of residents report fair or poor health — higher than the national proportion of 16%.

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43. Texas
> Drunkest city: Corpus Christi
> Pct of MSA adults binge or heavy drinking: 27.5%
> Pct. of state adults binge or heavy drinking: 16.0%
> Pct of driving deaths alcohol related: 33.1%

With about 16% of Texas adults reporting heavy or binge drinking, excessive alcohol consumption is not especially common across the Lone Star State. There is one glaring exception, however. More than one quarter of all adults in Corpus Christi report drinking to excess on a regular basis, a higher share than in all but three other cities in the United States. Victoria, where 24.7% of adults report excessive drinking habits, is the next heaviest drinking Texas city.

44. Utah
> Drunkest city: Salt Lake City
> Pct of MSA adults binge or heavy drinking: 12.6%
> Pct. of state adults binge or heavy drinking: 9.3%
> Pct of driving deaths alcohol related: 19.1%

In Salt Lake City, 12.6% of adults report heavy or binge drinking, the highest share of any metro area in the state, but the lowest share compared to the other cities on this list. This may not be surprising considering that only 9.3% of Utah’s adults drink excessively, tied with Tennessee as the lowest proportion of any state, and well below the national percentage of 15.0%. Utah also consumes the least amount of beer per capita. About three-fifths of Utah’s residents belong to The Church of Jesus Christ of Latter-day Saints, a religion that forbids drinking.

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45. Vermont
> Drunkest city: Burlington-South Burlington
> Pct of MSA adults binge or heavy drinking: 20.2%
> Pct. of state adults binge or heavy drinking: 19.4%
> Pct of driving deaths alcohol related: 33.3%

The Burlington area is the only metro in Vermont. As a result, the 20.2% of adults reporting excessive drinking is both the highest and the lowest proportion in Vermont. Still, area residents are more likely to drink excessively than their peers statewide. The metro is home to the University of Vermont and several other colleges, where students tend to consume more alcohol than elsewhere. According to data from beer industry data company Beer Insights, an average Vermont resident consumes around 36 gallons of beer annually, the fifth highest amount compared to other states. Each year, one-third of driving fatalities in the Burlington area are alcohol related. While this is well below the statewide incidence of 37%, it is still higher than the nationwide incidence of 31%.