title: Developmental trajectories of substance use from early to late adolescence: a comparison of rural and urban youth.
abstract: OBJECTIVE
  This study investigated differences in the development of heavy drinking and marijuana use among students in urban and rural areas and assessed whether any such differences can be accounted for by locality differences in racial/ethnic makeup, social disorganization/low social bonding, feelings of despondency and escapism, and the availability of drugs.
  
  
  METHODS
  Drawn from 62 South Dakota middle schools involved in a drug prevention field trial, participating students were assigned to a locality category based on the location of their seventh-grade school. Schools in metropolitan areas were distinguished from schools in nonmetropolitan areas. Schools in nonmetropolitan areas were further distinguished into those in micropolitan (medium and large towns) and noncore (rural areas without towns and with small towns) areas. We used latent growth curve analysis to model the influence of locality on the development of heavy drinking and marijuana use from ages 13 to 19 and to determine whether differences in development across locality were attributable to location-based differences in race/ethnicity, social disorganization/bonding, feelings of despondency and escapism, and alcohol and marijuana availability.
  
  
  RESULTS
  Heavy drinking increased at a faster rate among youth living in micropolitan areas compared with youth living in metropolitan areas. Marijuana use increased at a faster rate among youth living in metropolitan and micropolitan areas compared with youth living in noncore areas. Differences in the rate of change in heavy drinking were attributable to differences in the racial/ethnic composition of metropolitan and micropolitan areas. Differences in the rate of change in marijuana use were attributable to differences in residential instability and marijuana availability.
  
  
  CONCLUSIONS
  This study underscores the diversity of drug use within rural communities, suggesting that living in a very rural area is protective against some forms of drug use but that living in a rural area that includes a medium or large town is not.
authors.affiliation: RAND, 4570 Fifth Avenue, Pittsburgh, Pennsylvania 15213, USA. martino@rand.org
authors.forename: Steven C
authors.initials: SC
authors.lastname: Martino
authors.forename: Phyllis L
authors.initials: PL
authors.lastname: Ellickson
authors.forename: Daniel F
authors.initials: DF
authors.lastname: McCaffrey
mesh_terms: D000124:Achievement; D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000517:prevention & control; D000437:Alcoholism / Q000453:epidemiology* / Q000517:prevention & control; D000850:Anomie; D003430:Cross-Sectional Studies; D003674:Defense Mechanisms; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005195:Family Relations; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology* / Q000517:prevention & control; D015233:Models, Statistical; D009769:Object Attachment; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012931:Social Environment; D013023:South Dakota; D014505:Urban Population / Q000706:statistics & numerical data*