Earlier this week, the Centers for Disease Control and Prevention (CDC) released its 2011 Youth Risk Behavior Surveillance study. The annual survey, which reviews unhealthy behavior among 9th to 12th graders, reported that more than a third of high school students had consumed alcohol and more than one in five reported having engaged in binge drinking in the past 30 days. Based on the report, 24/7 Wall St. identified the states where binge drinking among teens occurs most.

Most of the states on this list are located in the western half of the United states; that is, in the Southwest, the Northwest and Midwest, including South and North Dakota, Montana and Wyoming. In most of these states the population is spread out geographically in small towns rather than large metropolitan areas.

This story was originally published by 24/7 Wall St. 

In the 10 states on our list, at least 23.5% of surveyed teens reported drinking at least five drinks in a row within a few hours in the previous 30 days, compared to the 21.9% nationwide. In Arizona, that number was 26.5%. In these states, while the number of high school students reporting having their first drink before the age of 13 was relatively low, the number who have ever consumed at least one alcoholic beverage is higher than most of the country.

While there appears to be no strong relationship between binge drinking and other risky behavior, such as tobacco and drug use, drunk driving was the exception. Of the 10 states on our list, six were in the top 15 for reporting driving after consuming alcohol in the 30 days prior to being surveyed. In North Dakota and Wyoming, 11.7% of high school students said they had driven one or more times after having at least one drink in the past month — the highest proportion in the country. These students also reported among the highest rates of riding with someone else who had been drinking.

24/7 Wall St. considered additional risk behavior data from the CDC to determine whether there was a relationship between drinking among youth and problems among the state’s adults. It appears that states that have binge drinking and drunk driving problems among high school students often have those problems among adults as well. In Wisconsin, 21.6% of adults claimed they had engaged in binge drinking in the past 30 days — the highest rate of any state. The majority of these states had among the highest percentage of driving fatalities caused by someone driving with blood alcohol levels over the legal limit.

We examined factors that some might expect to be common in states that have high incidence of teen drinking. However, many of these factors, including educational attainment, drug use and crime, did not appear to bear strong relations to teen drinking.

24/7 Wall St. reviewed the CDC’s behavioral data, which included reported alcohol and drug consumption for surveyed high school students. The survey, which also looked at other types of health-related behavior, as well as depression, was conducted between September 2010 and December 2011. We also included drunk driving fatalities for 2009, the most recent available year, provided by the U.S. Department of Transportation. And 24/7 obtained education attainment data from the U.S. Census Bureau for 2010, the most recent available year.

These are the 10 states with the most underage drinking.

10. Texas
> Binge drinking: 23.5% (10th highest)
> Driving after drinking alcohol: 10.2% (8th highest)
> Drank alcohol before age 13: 22.8% (10th highest)

High school students in Texas consistently have among the worst drinking habits in the country. Besides having the 10th-highest rate of binge drinking in the U.S., the state is among the 10 worst in the country for 9th through 12th graders drinking and driving, and current alcohol use. According to the CDC’s report, nearly one in three high schoolers reported having been in a car with a driver who had been drinking — the highest proportion in the country. According to the Department of Transportation, 40% of all driving fatalities in Texas were related to drunk driving, tied as the fifth-highest rate in the country.

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9. Ohio
> Binge drinking: 23.7% (tied for 8th highest)
> Driving after drinking alcohol: 7.2% (23rd highest)
> Drank alcohol before age 13: 18.1% (26th highest)

In Ohio, more than 70% of high school students reported having at least tried a drink — the eighth-highest rate in the country. Also, 38% reported drinking alcohol in the past 30 days, one of the highest percentages in the country. The state also appears to have severe problems with tobacco and drug use among its youth. Ohio has the eighth-highest rate of 9th to 12th graders smoking, the 10th-highest rate of reported marijuana use and the ninth-highest rate of needle drug use.

8. New Jersey
> Binge drinking: 23.7% (tied for 8th highest)
> Driving after drinking alcohol: 6.4% (33rd highest)
> Drank alcohol before age 13: 14.4% (3rd lowest)

More notable than their binge drinking habits, New Jersey 9th to 12th graders rank third in the nation for current alcohol use at almost 43%. While the state’s high schoolers rank eighth in binge drinking, the adults fall in the middle of the pack for states with binge drinkers. New Jersey also has one of the lowest numbers of traffic fatalities due to alcohol.

7. New Hampshire
> Binge drinking: 23.8% (tied for 6th highest)
> Driving after drinking alcohol: 8.6% (17th highest)
> Drank alcohol before age 13: 14.3% (2nd lowest)

Just 14.3% of New Hampshire high school students tried alcohol before they were 13 years old, which is the second-lowest proportion in the country. Nevertheless, 38.4% of teens reported drinking alcohol in the past 30 days — a bigger rate than in most other states. Of those high schoolers who responded, 5.6% reported drinking alcohol on school property, the sixth-highest percentage in the country.

6. Wisconsin
> Binge drinking: 23.8% (tied for 6th highest)
> Driving after drinking alcohol: 8.7% (15th highest)
> Drank alcohol before age 13: 18.6% (23rd highest)

Wisconsin high school aged children are some of the biggest binge drinkers in the county, and so are their parents. Almost 22% of adults in Wisconsin reported binge drinking in the past 30 days (the national average is less than 15%). In a state where the professional baseball team is named the Milwaukee Brewers, drinking is certainly socially acceptable.

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5. Wyoming
> Binge drinking: 25.1% (5th highest)
> Driving after drinking alcohol: 11.7% (tied for the highest)
> Drank alcohol before age 13: 23.5% (7th highest)

Wyoming has the fifth-highest percentage of binge drinking and the highest percentage of high schoolers who drink and drive. This is in line with overall population of the state, which ranks first for the incidence of drinking and driving per 100,000 people at 1,039 (almost 35% more than the next highest state, South Dakota, with 772 incidences per 100,000 people). Wyoming also happens to rank seventh for the percentage of high school students who reported drinking before the age of 13. This stat is notable when considering that the American Psychological Association reports that children who begin drinking before the age of 13 have a 38% higher chance of developing alcohol dependence.

4. Montana
> Binge drinking: 25.2% (4th highest)
> Driving after drinking alcohol: 10.6% (6th highest)
> Drank alcohol before age 13: 21.4% (12th highest)

Montana has the fourth-highest incidence of binge drinking among high schoolers and the second-highest percentage who have ever consumed alcohol. The state’s youth also rank in the top five for students having ridden with a driver who has been drinking. Montana also reports the third-highest percentage of traffic fatalities involving alcohol (almost twice the national average). The Underage Drinking Enforcement Training Center estimates that underage drinking costs the state $200 million a year. That’s more than $2,500 per youth.

3. North Dakota
> Binge drinking: 25.6% (3rd highest)
> Driving after drinking alcohol: 11.7% (tied for the highest)
> Drank alcohol before age 13: 16.7% (32nd highest)

North Dakota, which has the third-highest percentage of teens who binge drink, has the highest percentage of teens who drink and drive. According to the report, 11.7% of North Dakota teens have driven after drinking in the past 30 days, which is almost 43% more than the national average of 8.2%. Incidence of underage drinking and driving has increased 20.9% from 2000 to 2010. Even 19-year-old John Mitzel, the North Dakota House of Representatives candidate who has a Republican endorsement, was caught for underage drinking this March while riding as a passenger in a car.

2. South Dakota
> Binge drinking: 26.2% (2nd highest)
> Driving after drinking alcohol: 10.9% (5th highest)
> Drank alcohol before age 13: 19% (21st highest)

South Dakota high schoolers rank second in terms of their binge drinking and third in the country for having seriously considered attempting suicide. They are also big smokers. Over 23% of South Dakota 9th to 12th graders currently smoke, compared to the national median of 17.4%. South Dakota ranks fifth in the percentage of teens reporting having driven after drinking. This is an expensive problem for a state with a population of just over 800,000. The Underage Drinking Enforcement Training Center estimates that underage drinking costs the state $300 million a year. That’s more than $3,436 a year per each youth.

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1. Arizona
> Binge drinking: 26.5% (the highest)
> Driving after drinking alcohol: 9.3% (11th highest)
> Drank alcohol before age 13: 21.3% (13th highest)

Arizona has the highest percentage of high school students who binge drink at 26.5%. Unlike the rest of the states in the top 10 for binge drinking, Arizona ranks in the top 10 for the percentage of high schoolers who have reported the use of methamphetamines (sixth), inhalants (sixth) and heroin (eighth). Arizona also reports the second-highest percentage of 9th to 12th graders who have seriously considered attempting suicide at 18.7%.