26. Montana
> Drunkest city: Missoula
> Pct of MSA adults binge or heavy drinking: 22.1%
> Pct. of state adults binge or heavy drinking: 18.8%
> Pct of driving deaths alcohol related: 52.2%

In Missoula, 22.1% of men and women report heavy or binge drinking, a higher share than any other metro in the state. Missoula leads Montana, and nearly the country, in another measure as well. More than 52% of driving deaths in the metro area are alcohol related, 21.2 percentage points above the national proportion and the third highest of any city. Despite having an above average share of residents that drink to excess, Missoula’s population self-reports as healthier than the country as a whole. Nationally, 16.0% of adults report being in only fair or poor health, while just 11.4% of Missoulians say the same.

27. Nebraska
> Drunkest city: Omaha-Council Bluffs
> Pct of MSA adults binge or heavy drinking: 21.1%
> Pct. of state adults binge or heavy drinking: 19.5%
> Pct of driving deaths alcohol related: 42.3%

Nebraska has one of the highest rates of excessive alcohol use in the country. While 15.0% of U.S. adults report binge or heavy drinking, 19.5% of Nebraskan adults report such a habit. In Omaha, 21.1% of adults report excessive drinking, the 33th highest share of any U.S. metropolitan area. Drinking has resulted in some fatalities on Omaha’s roads. Alcohol is a factor in 42.3% of all driving deaths in the metropolitan area each year, compared to 31.0% of alcohol-related car accident fatalities nationwide.

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28. Nevada
> Drunkest city: Reno
> Pct of MSA adults binge or heavy drinking: 20.4%
> Pct. of state adults binge or heavy drinking: 18.2%
> Pct of driving deaths alcohol related: 31.5%

In Nevada, 18.2% of Nevada’s population reports binge or heavy drinking, the 17th highest share of all states. Some might expect that rank to be higher given Las Vegas’s reputation — Sin City is the setting of a great deal of excessive drinking. Much of the binge drinking, however, is done by tourists and not state residents. Las Vegas is not even the heaviest drinking city in the state. That title goes to Reno, where more than one in five adults engage in binge or heavy drinking, compared to a national share of 15.0%.

29. New Hampshire
> Drunkest city: Manchester-Nashua
> Pct of MSA adults binge or heavy drinking: 17.6%
> Pct. of state adults binge or heavy drinking: 17.6%
> Pct of driving deaths alcohol related: 33.6%

In Manchester-Nashua 17.6% of adults report excessive drinking, higher than the national proportion of 15.0%. However, the metro is the only urban area in New Hampshire, so by default it has the highest share of adults drinking to excess. The Manchester metro area is located on the state’s border. Not only are area residents more likely to drink excessively compared to most Americans, but also New Hampshire’s 0% sales tax typically attracts high numbers of shoppers from other states, including alcoholic beverage shoppers.

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30. New Jersey
> Drunkest city: Atlantic City-Hammonton
> Pct of MSA adults binge or heavy drinking: 18.1%
> Pct. of state adults binge or heavy drinking: 16.1%
> Pct of driving deaths alcohol related: 24.3%

America’s Playground, Atlantic City, has the highest share of adults drinking to excess in New Jersey. While 15.0% of U.S. adults report binge or heavy drinking, 18.1% of Atlantic City adults said the same. While that share is high, it is actually lower than many of the cities in other states with a large share of residents drinking to excess. Alcohol abuse has been shown to be linked to health problems, and indeed, Atlantic City actually has significantly more life lost due to premature death than the state, at 7,918 years per 100,000 residents versus 5,558 per 100,000 residents, respectively.