Online Program

Differences in Recent Alcohol, Tobacco, and Substance Use between Rural and Urban Students

Monday, November 2, 2015

K. Nikki Barefoot, Psy.D., Rural Health Research Institute, Georgia Southern University, Statesboro, GA
Jacob Warren, PhD, MBA, Center for Rural Health and Health Disparities, Mercer University School of Medicine, Macon, GA
K. Bryant Smalley, PhD, PsyD, MBA, Rural Health Research Institute, Georgia Southern University, Statesboro, GA
objective: The purpose of the current study was to examine rural-urban differences in the prevalence of past 30-day use of each of 11 substances within each middle and high school grade level (i.e., 6th-12th).

methods: Data for the current study came from the 2013 Georgia Student Health Survey II. A total of 513,909 student responses were included in the current analysis (18.2% rural; 80.2% urban). As part of the survey, students indicated their past 30-day use of 11 substances: alcohol, smoking tobacco, chewing tobacco, marijuana, cocaine, inhalants, steroids, ecstasy, methamphetamines, hallucinogens, and prescription drugs.

results: Rural students in 6th-11th grades each were more likely to report using alcohol, smoking tobacco, and chewing tobacco in comparison to their urban peers, and rural 7th graders were also more likely to report prescription drug use. Differences in illicit drug use were found exclusively in the high school sample (with higher rates among urban students across drugs in 10th-12th grade), and these differences increased in magnitude across grades. However, by 12th grade, urban students had the highest rates across the majority of substances; with the exception of chewing tobacco (which remained higher among rural students) and smoking tobacco (no differences).   

conclusions:  Rural-urban differences in substance use depend largely upon grade level, with rural middle school students demonstrating consistently higher rates of alcohol and tobacco use, and urban high school students demonstrating higher rates of illicit drug use. These results support the need for future investigations of the differing motivations for substance use between rural and urban students.

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Public health or related research

Learning Objectives:
Discuss how cultural and/or structural aspects of geographic location (i.e., urban or rural) may influence the substance use patterns of middle and high school students. Describe the variations in past 30-day substance use between rural and urban students in grades 6-12.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I possess a doctorate of clinical psychology (Psy.D.) and have conducted extensive research examining rural-urban differences in health-related behaviors and outcomes. I additionally work as a postdoctoral researcher on the grant that partially supported the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.