Alcohol and tobacco use robbed the entire human population of an estimated quarter of a billion adjusted life years in 2015 alone, according to a new estimate.

Nowhere is the loss greater than in Europe, according to the review published today by the journal Addiction.

“European regions had the highest prevalence of heavy episodic alcohol use and daily tobacco use,” writes the international team of authors. “(The) high-income North America region had among the highest rates of cannabis, opioid and cocaine dependence.”

The global estimate is that about one in seven adults smoke tobacco, and one in five have drank heavily within the last month, according to the paper.

The health effects snapshot is based on the year 2015.

Europe’s various regions report the most serious consumption of both smokes and booze. Roughly half of drinkers in Central and Eastern Europe report heavy usage, and Western Europe is not far behind, at 40 percent. Roughly a quarter of the Eastern European population smokes, and it’s a little more modest in Central Europe and Western Europe (23.7 percent and 20.9 percent, respectively).

North America had among the highest rates of cannabis, opioid and cocaine dependence, at 748, 650 and 301 individuals per 100,000 people, according to the results. Australia and New Zealand, on the other hand, had a high rate of amphetamine use, at 491.5 cases per 100,000 people. These translated to major health outcomes, according to statistical estimates based on data from the World Health Organization, the United Nationals Office on Drugs and Crime and the Institute for Health Metrics and Evaluation.

Deaths were greatest for tobacco, at 110 per 100,000 people, followed by 33 deaths per 100,000 people for alcohol, and 6.9 death per 100,000 for illegal drugs, according to the paper.

The “disability-adjusted life years” decreased in accordance with each category. That total was 170 million from tobacco and 85 million from alcohol.

All the illicit drugs combined accounted for 27.8 million disability-adjusted life years, the scientists found.

But wide other swaths of the world – especially the developing world in Africa, Latin America and parts of Asia – do not have health and substance-abuse data, the paper adds.

The 17 listed authors of the paper are affiliated with institutions in Australia, the United Kingdom, Canada, the United States and Portugal.