ArticlePreventive medicine2025
Examining US adolescent cigarette smoking prevalence by rurality and gender, 2002-2019.
Article in Preventive medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- Place-based risk: Examining relationships between adolescent perceptions of community risk factors and adolescent substance use across geographic contexts.American journal of community psychology · 2026Article
- Application of Spatial Methods in Rural Cancer Control Research in the United States.Current epidemiology reports · 2026Review
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4 authors.
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Abstract
objectiveExamine changes in cigarette smoking prevalence among US adolescents by rural-urban residence, gender, and time.
methodsWe compared trends in smoking prevalence by rural-urban residence and gender using 18 years of cross-sectional data (2002-2019) from 298,530 respondents aged 12-17 in the US National Survey on Drug Use and Health. The two primary outcomes were past-month and daily smoking prevalence. Weighted logistic regression models tested whether smoking prevalence varied by rural-urban residence, gender, and time along with two-way and three-way interactions of these variables.
resultsPast-month and daily smoking declined over time for all four rural-urban residence and gender combinations. Regarding past-month smoking, there was a significant rural-urban residence by time interaction (p < .001) with higher prevalence and slower rates of decline among rural (adjusted odds ratio [AOR] = 0.86; 95 %CI = 0.85,0.87) versus urban participants (AOR = 0.83; 95 %CI = 0.82,0.84). A significant gender by time interaction (p < .001) was also observed. The rate of decline was faster among females (AOR = 0.82; 95 %CI = 0.81,0.83) versus males (AOR = 0.85; 95 %CI = 0.84,0.86) with prevalence initially higher (2002-2003) yet ending lower (2018-2019) among females. Regarding daily smoking, there was a significant rural-urban residence by time interaction (p = .005) with higher prevalence and slower rates of decline among rural (AOR = 0.82; 95 %CI = 0.80,0.85) versus urban participants (AOR = 0.79; 95 %CI = 0.78,0.80).
conclusionsFindings provide novel evidence of shrinking yet persistent rural disparities in both past-month and daily smoking, and less declines in past-month smoking among males over time. Together, findings support continued need for tobacco control and regulatory efforts to reduce adolescent smoking and specific efforts to reduce rural and gender disparities.
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