Understanding Differences in Rural and Urban Adolescent and Young Adult Substance Use

Research center:
Lead researcher:
Project funded:
September 2017
Project completed:
December 2019

Early results from the 2016 Monitoring the Future annual survey show a continued long-term decline in adolescent substance use across marijuana, alcohol, tobacco, and misuse of some prescription medications. However, it is unclear whether these changes have also taken place among rural adolescents and young adults who have historically shown higher alcohol and drug use rates than their urban counterparts. The project's purposes are to (1) establish a current prevalence of rural-urban adolescent and young adult substance use and (2) understand the influence of protective and risk factors in predicting substance use for rural and urban adolescents. Using data from the 2010-15 National Survey on Drug Use and Health, we will employ a combination of bivariate and multivariate techniques to assess substance use prevalence and to identify protective and risk factors. At the bivariate level, we will use chi-square tests to compare the rural-urban prevalence of substance use and differences on covariates among rural and urban populations. At the multivariate level, we will conduct logistic regression analyses to understand whether rural-urban differences in prevalence may be explained by socio-demographic characteristics, and whether risk and protective factors differ for rural and urban adolescents and young adults.


  • Rural-Urban Differences in the Decline of Adolescent Cigarette Smoking
    Journal Article
    Maine Rural Health Research Center
    Date: 03/2019
    Comparing survey data from 2008-2010 with 2014-2016, we examined change over time in cigarette smoking among rural and urban adolescents. We found that both rural and urban rates declined, but the decrease was smaller in rural counties, which widened the rural-urban gap in adolescent smoking rates.
  • Substance Use Among Rural and Urban Youth and Young Adults
    Policy Brief
    Maine Rural Health Research Center
    Date: 11/2020
    This study uses national data to examine rural-urban differences in the rates of substance use among youth and young adults. Findings can help inform rural-specific prevention strategies and research targeting rural communities.