A REPORT released by the Australian Institute of Health and Welfare (AIHW) has shown people in rural and remote NSW are lighting up at twice the rate as their big city counterparts.
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It also showed crystal meth or ice to have replaced powder as the most popular form of drug used.
The National Drug Strategy Household Survey reported people living in rural and remote areas in the state were more likely to use methamphetamines, smoke daily or partake in risky drinking behaviour compared to metropolitan areas.
AIHW spokesperson Geoff Neideck said the data was collected from 24,000 people in the second half of 2013.
It found more than two in five Australians either smoked daily, drank alcohol in ways that placed them at risk or harm, or used an illicit drug in the previous 12 months.
Mr Neideck said NSW itself was sitting below the national average of smoking, drug and alcohol use, but all three sectors rose considerably as the level of remoteness did.
Overall levels of meth use were stable between 2010, when the survey was last conducted, and 2012, but there was a change in the most popular form used, with crystal meth or ice replacing powder as the preferred form of the drug.
Among recent meth users, ice use increased from 22 per cent to 50 per cent.
There was also a trend to more frequent use, with 15.5 per cent of recent users using it daily or weekly, compared to 9.3 per cent in 2010.
People who mainly used ice were far more likely to use it on a regular basis than those who used meth in other forms.
A quarter of ice users used the drug at least weekly, compared to 2.2 per cent of those who mainly used powder.
There was a significant rise in misuse of pharmaceuticals, with 900,000 people reporting using a pharmaceutical drug for non-medical purposes.
Of these, almost three in 10 used weekly or more often.