The United States leads the world in rates of experimenting with marijuana and cocaine despite strict drug laws, World Health Organization researchers said on Tuesday.
Countries with looser drug laws have lower rates of abuse, the researchers report in the Public Library of Science journal PLoS Medicine.
The survey of 54,000 people in 17 countries found that 16 percent of people in the United States had used cocaine in their lifetimes -- far higher than the next highest rate, found in New Zealand, where 4.3 percent of people reported having used cocaine.
More than 42 percent of Americans admitted to having tried cannabis, closely followed by 41 percent in New Zealand, Dr. Louisa Degenhardt of the University of New South Wales in Sydney, Australia and an international team of colleagues found.
Americans were also the most likely to have smoked, with 74 percent saying they used tobacco at some time in their lives, although current smoking rates are far lower at 21 percent.
The next-highest lifetime smoking rate was found in Lebanon at 67 percent, with 60 percent of Mexicans and the 61 percent of Ukrainians having ever smoked.
"Globally, drug use is not distributed evenly and is not simply related to drug policy, since countries with stringent user-level illegal drug policies did not have lower levels of use than countries with liberal ones," Degenhardt's team wrote.
Alcohol was by far the most common substance used, the researchers found in their face-to-face interviews with people.
"Alcohol use by age 15 years was far more common in European countries than in the Middle East and Africa," they wrote.
By the age of 21, up to 99 percent of Europeans, 92 percent of Japanese, 94 percent of New Zealanders and 93 percent of people in the Americas had tasted alcohol.
"Estimates were lower in the Middle East and Africa (40 percent to 63 percent)" the researchers wrote.
"In the Netherlands, Belgium, France, Germany, and New Zealand, more than 60 percent of young people had started to drink by age 15 years," they added.
"These findings add to our understanding of substance abuse world-wide, and suggest that drug use is still a major problem in this country, pointing to the need for more effective prevention interventions," U.S. National Institutes of Health director Dr. Elias Zerhouni added in a statement.
The researchers said their findings shed light on drug, alcohol and smoking policy.
"The use of drugs seems to be a feature of more affluent countries," they wrote.
"The United States, which has been driving much of the world's drug research and drug policy agenda, stands out with higher levels of use of alcohol, cocaine, and cannabis, despite punitive illegal drug policies, as well as (in many U.S. states), a higher minimum legal alcohol drinking age than many comparable developed countries," they added.
"The Netherlands, with a less criminally punitive approach to cannabis use than the U.S., has experienced lower levels of use, particularly among younger adults."
The study is available here (Reporting by Maggie Fox, Editing by Michael Kahn and David Wiessler)