This study compared levels of drug use and risk and protective factors among 18,767 adolescent youths from communities of less than 50,000 in population living either on farms, in the country but not on farms, or in towns. Current alcohol use, smokeless tobacco use, inhalant use, and other illicit drug use were more prevalent among high school-aged youths living on farms than among those living in towns. Prevalence of drug use did not significantly vary across youths living in different residential contexts among middle school youths. While risk and protective factors showed associations of similar magnitude with drug use across residential location, high school students living on farms were exposed to greater numbers of risk factors across multiple domains than were students living in towns. The findings suggest that outreach to farm-dwelling youths may be particularly important for interventions seeking to prevent adolescent drug use in rural settings.
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