Massachusetts is continuing to struggle with the health effects of illegal drugs while tobacco remains the state's leading cause of preventable death and disease.

According to a new Massachusetts Health Council report, eastern Massachusetts has been particularly hard hit.

The study points to a federal 2011 report that found the Boston metropolitan area had the highest rate of emergency department visits involving illicit drugs of any of 11 major metropolitan regions in the U.S., topping New York City, Chicago, and Detroit.

The Boston region — which includes Suffolk, Middlesex, Norfolk, Plymouth, and Essex counties, plus two counties in New Hampshire — ranked first among the 11 metropolitan regions for hospital visits specifically involving heroin.

The report also found that nearly 9,000 Massachusetts residents die each year from the effects of smoking.