Differences in Cigarette Use and the Tobacco Environment Among Youth Living in Metropolitan and Nonmetropolitan Areas

J Rural Health. 2018 Dec;34(1):80-87. doi: 10.1111/jrh.12194. Epub 2016 Jul 22.


Purpose: To examine cigarette use and the tobacco-related environment among adolescents living in metropolitan and nonmetropolitan areas.

Methods: Data from adolescents ages 14-17 that completed the 2012 Florida Youth Tobacco Survey were analyzed (n = 40,746). This includes a representative sample of middle and high school students throughout the state.

Results: Nonmetropolitan adolescents were more likely than metropolitan adolescents to report lifetime smoking, past 30-day smoking, daily smoking, initiating smoking at younger ages, having smoked a greater number of cigarettes in their lifetime and in the past 30 days, friend acceptance of adult smoking, a parent offering them a cigarette, living with a smoker, and that smoking was allowed in their home. Nonmetropolitan adolescents were also more likely to have seen tobacco ads the last time they visited convenience marts, gas stations, grocery stores, and big box stores, and flavored tobacco products or ads for them. These differences persisted after controlling for demographics.

Conclusions: The present results suggest vast differences in smoking behavior among nonmetropolitan and metropolitan adolescents and that targeting social and environmental factors may be beneficial for reducing tobacco disparities among nonmetropolitan adolescents.

Keywords: adolescents; cigarette; health disparities; rural; tobacco.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Female
  • Florida / epidemiology
  • Humans
  • Male
  • Population Surveillance / methods
  • Rural Population / statistics & numerical data
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Students / statistics & numerical data*
  • Surveys and Questionnaires
  • Urban Population / statistics & numerical data