A new report on substance abuse and mental health shows that while more people are quitting smoking (or not starting in the first place), alcohol and illicit drug use still remain steady. The study also shows that drug use varies widely across the country; for example, the rate of illicit drug use among people ages 12 and older in Rhode Island is more than half (12.5 percent) of what it is in Iowa (5.2 percent). The report from the Substance Abuse and Mental Health Services Administration (SAMHSA) collected data from 135,672 people in 2006 and 2007 and is compared to data from 2005-2006. The data suggests that perceived risk contributes to the numbers. If people think it’s risky to use cigarettes, drugs, and alcohol, they tend to engage in them less. Smoking declined from 24.96 percent to 24.63 percent, with the greatest decrease among those ages 12 to 25. California had the second lowest smoking rate (19.79 percent) behind Utah (17.51 percent), and the highest percentage (77.35 percent) of people who regard smoking as a health hazard. West Virginia, on the other hand, had the highest rate of cigarette smokers of all states (31.10 percent) and the lowest perception of risk level (67.88 percent). Colorado is the only state showing an increase in tobacco use (from 26.5 percent to 29.8 percent), and seven states had declines: Idaho, Massachusetts, Michigan, Montana, New York, Utah, and West Virginia. Alcohol still ranks as the most commonly abused substance. North Dakota ranked highest in binge drinking (among legal age and underage drinkers) and ranked 47th among states in perception of risk. New Hampshire, which ranked third behind Rhode Island and Connecticut, had the lowest percentage (33.21 percent) of perception of risk. Rhode Island also had the highest percentage of people aged 12 and over who reported needing but not receiving substance-abuse treatment. Other states that ranked highest for needing but not receiving treatment for alcohol abuse were mostly Midwestern (Iowa, Minnesota, North Dakota, South Dakota, and Wisconsin) or Western (Colorado, Montana, and Wyoming). Massachusetts and the District of Columbia also ranked in the top ten. “We produce this as a reference document for the states,” says Joe Gfroerer, director of the division of population surveys. “It can lead to more in-depth analysis and discussion about whether programs within the states can help with problems.”