- Moderate
- Couple people often appear drunk on the strip. In one random encounter on the strip, a drunk soilder is seen throwing up.
- Packs of cigarettes, cigars, and their ashtrays are seen around during exploration. You are also able to pick them up. But all acts of smoking can only be done by other characters.
- Theres a couple casinos open in new vegas, they have a bar where alcohol is sold but mostly consist of gambling, which the player can participate in by placing bets while playing roulette, blackjack, and slots.
- There is a liquor store in the westside part of new vegas. There are also a couple saloons in the wasteland outside of new vegas.
- Characters drink and smoke.
- Alcoholic beverages and fictional drugs can be purchased and used, causing the screen to go blurry and altering player attributes.
- The player character can become addicted to alcohol or drugs and need to seek treatment.
- Some characters are junkies and drug manufacturers.