Adolescent daily cigarette smoking: is rural residency a risk factor?
BACKGROUND
Daily cigarette smoking among US adolescents remains a significant public health problem. Understanding risk is important in order to develop strategies to reduce this type of tobacco use.


OBJECTIVE
The primary objective of this research was to examine whether rural residency is an independent risk factor for being a daily smoker among adolescents ages 12 to 18 years.


METHODS
This is a cross-sectional study where univariate, bivariate, and multivariate analyses were performed on a merged 1997-2003 Youth Risk Behavior Surveillance System dataset to determine whether rural residence was a significant risk factor for daily cigarette smoking, after adjusting for demographic factors.


RESULTS
Using daily smoking as the dependent variable, initial multivariate analyses revealed that adolescents who lived either in suburban (OR=.34, CI=.32, .36) or urban (OR=.33, CI=.31, .35) locales were less likely to become daily smokers than adolescents living in rural locales. Subsequent logistic regression analysis yielded that rural youths who became daily smokers were more likely to: have used smokeless tobacco products in the past 12 months (OR=1.25, CI=1.04,1.51); be female (OR=1.42, CI=1.23, 1.64); be Caucasian (OR=1.53, CI=1.28, 1.84); have first smoked a whole cigarette when they were 12 years of age or younger (OR=2.08, CI=1.82, 2.38); and have smoked at school in the past 30 days (OR=14.52, CI=11.97, 17.60).


CONCLUSIONS
The results indicate that rural residency is a risk factor for tobacco use among US youth.
Lutfiyya
May Nawal
MN
University of Illinois, College of Medicine at Rockford, Rockford, Illinois, USA. lutfiyya@uic.edu
Shah
Kunal K
KK
Johnson
Mark
M
Bales
Robert W
RW
Cha
Isaac
I
McGrath
Cynthia
C
Serpa
Leigh
L
Lipsky
Martin S
MS
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010379:Peer Group; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012423:Rural Health; D012424:Rural Population / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology