Connection between Rurality and Perceived Permissiveness of Substance Use in Students

objectives: The purpose of the current study was to examine rural-urban differences, stratified across each grade level, with regards to the perceptions of adult and friend permissiveness toward alcohol, tobacco, and other substance use.

methods: The 2013 Georgia Student Health Survey II was administered in all 6th-12th graders in all Georgia public schools. A total of 513,909 student responses were included in the current sample. In terms of location, 18.2% of the total sample attended school in a rural county (84 out of 159 GA counties). Perceived permissiveness of friends and close adults was assessed for alcohol, tobacco, marijuana, and other drugs. Odds ratios were calculated to examine rural-urban differences for each substance.

results: When examining friend permissiveness, the vast majority of significant differences showed higher levels of permissiveness in rural students than urban students. While several comparisons within adult permissiveness were not significantly different between urban and rural students, the first instance of urban permissiveness being higher did not occur until marijuana use perceptions by 10^th graders, whereas 10 of the 16 comparisons in 6^th through 9^th grade showed significantly more permissive adult attitudes in rural areas, including significant differences in each substance investigated.

conclusions: Our study finds that both grade and rural status strongly influence perceived permissiveness of both adults and friends toward substance use.  Overall, rural middle school students perceived much more permissive attitudes than did urban students, and perceptions of permissive attitudes grew steadily for alcohol, tobacco, and marijuana across ages for friends, but not for adults.  Research, policy, and practical implications will be discussed.