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Tobacco Use Among Rural and Urban US Middle and High School Students: National Youth Tobacco Survey, 2011-2016.

Authors
  • Wiggins, Amanda T1
  • Huntington-Moskos, Luz2
  • Rayens, Emily A3
  • Rayens, Mary Kay1, 4
  • Noland, Melody5
  • Butler, Karen1
  • Hahn, Ellen J1, 4
  • 1 College of Nursing, University of Kentucky, Lexington, Kentucky.
  • 2 School of Nursing, University of Louisville, Louisville, Kentucky.
  • 3 Center for Vaccines and Immunology, University of Georgia, Athens, Georgia. , (Georgia)
  • 4 College of Public Health, University of Kentucky, Lexington, Kentucky.
  • 5 College of Education, University of Kentucky, Lexington, Kentucky.
Type
Published Article
Journal
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
Publication Date
Jan 01, 2020
Volume
36
Issue
1
Pages
48–54
Identifiers
DOI: 10.1111/jrh.12356
PMID: 30865335
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Rural adolescents engage in higher smoking and smokeless tobacco use rates than those from urban communities; urban adolescents are more likely to use e-cigarettes. The study investigated whether place of residence (rural vs urban) is associated with tobacco use prevalence and change in prevalence among middle and high school students over time. We analyzed data from the National Youth Tobacco Survey (2011-2016). Multiple logistic regression methods for weighted survey data assessed the relationship of place of residence with current tobacco product use over time, adjusting for demographics. There was no difference in rate of change in use of any tobacco product between rural and urban middle or high school students. Adjusting for age, sex, race/ethnicity, and survey year, both middle and high school rural students were more likely to use cigarettes and smokeless tobacco, whereas urban high school students were more likely to use hookah. Significant polynomial trends were observed for e-cigarette and hookah use patterns, whereas linear changes in use patterns were detected for cigarette and smokeless tobacco use over time. Rural high school students are more likely to smoke cigarettes and use smokeless tobacco than their urban counterparts, although prevalence rates have decreased over time. However, use of hookah and e-cigarettes among middle and high school students has increased over time regardless of place of residence. To stem the rapid increase in use of hookah and e-cigarettes, comprehensive tobacco control policies are needed regardless of rural or urban location. © 2019 National Rural Health Association.

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