Using the Rural-Urban Continuum to Explore Adolescent Alcohol, Tobacco, and Other Drug Use in Montana

Abstract

The purpose of the study was to compare 30–day prevalence of alcohol, tobacco, and other drug use among twelfth-grade students in Montana across a rural-urban continuum during 2000, 2002, and 2004. The methods include an analysis of the Montana Prevention Needs Assessment (N = 15,372) using multivariable logistic regression adjusting for risk factors, protective factors, and demographics variables. Findings revealed that adolescent substance use varies across the rural-urban continuum. Risk of cigarette, smokeless tobacco, and alcohol use increased in more rural counties while risk of marijuana, LSD, and any drug decreased in more rural counties. The specificity provided through use of such a classification scheme has important implications for designing effective drug-prevention programs across diverse settings.

KEYWORDS:

• adolescent
• rural
• substance use

Acknowledgments

The authors wish to thank the Montana Addictive and Mental Disorder Division, Montana Department of Public Health and Human Services for their support of this study.

Notes

Note: No county in Montana has a Rural-Urban Continuum Code of 1, 2, or 4.

Note: CI = Confidence Interval.

^a A positive estimate indicates a higher probability toward usage from metro and urban to rural settings. A negative estimate indicates a lower probability toward usage from metro and urban to rural settings.

^b Variables adjusted for included all risk and protective factors, age, gender, and race/ethnicity.

Additional information

Notes on contributors

Carl L. Hanson

Carl Hanson, PhD, CHES, Faculty members or students at Brigham Young University.

Michael D. Barnes

Michael Barnes, PhD, CHES, professor and MPH program director, faculty members or students at Brigham Young University.

Dennis Eggett

Dennis Eggett, PhD, associate professor of statistics and director of the Center for Collaborative Research and Statistical Consulting, faculty members or students at Brigham Young University.

Chelsea McKell

Chelsea McKell, MPH., faculty members or students at Brigham Young University.

Peter Reichman

Peter Reichman, MPH [c], faculty members or students at Brigham Young University.

Mike Havens

Michael Havens, PhD, professor and department chair, Montana State University-Billings, Department of Psychology.