#42 Adolescent alcohol, tobacco and other drug use along the rural-urban continuum

PURPOSE: This paper employs measures of rurality of county and rural/urban location of residence to assess the level of substance use and salience of the risk and protective factors that are frequently targeted by drug prevention programs. Multivariate analysis assesses the impact of rurality on use of four substances while controlling for other risk and protective factors. METHODS: USDA Economic Research Service County Typology Codes for county of residence and self-reported size of community of residence are applied to the analysis of data from a survey of adolescent alcohol, tobacco and other drug use behavior and selected risk and protective factors. Data are drawn from the Florida Youth Substance Abuse Survey (FYSAS) 2000, a school-based self administered statewide survey of students in grades 6 through 12 fielded between November 1999 and January 2000. RESULTS: Bivariate correlations demonstrate associations between many risk and protective factors and the rurality of county of residence. Multivariate logistic regression analysis, controlling for risk and protective factor domains, shows that rurality of residence and rurality of county both strongly and independently increase the risk of trying smokeless tobacco. Rurality of county also increases the odds of having smoked cigarettes. However, it has a weak but significant protective effect with respect to lifetime use of alcohol. Neither measure of rurality was a significant risk or protective factor for lifetime use of marijuana. CONCLUSIONS: Findings suggest that it is inappropriate to discuss the relationship between rurality and ATOD use as if ATOD use is a unitary phenomenon. Patterns of use and the salience of risk and protective factors vary across substances. In addition, the findings reiterate the need for more gradations in measures of rurality than the metro/non-metro dichotomy reported in most government documents.