Risky Substance Use Behaviors Among Adolescents Residing in Non-Metropolitan and Metropolitan Counties in the United States, 2017-2018

Overview of Key Findings Tobacco Use. The prevalence of any past year tobacco use was significantly higher among non-metropolitan than metropolitan adolescents (13.9% vs. 8.3%). Daily cigarette use in the past 30 days was more than 3 times more prevalent among non-metropolitan than metropolitan adolescents (1.0% vs. 0.3%) and the difference was also statistically significant. Alcohol Use. Alcohol was the most commonly used substance among both non-metropolitan and metropolitan adolescents, although the differences in prevalence rates for past year and past 30-day alcohol use were not statistically significant. In the past year, 21.8% of non-metropolitan and 21.7% of metropolitan adolescents drank alcohol. In the past 30 days, 9.3% of non-metropolitan adolescents and 9.6% of metropolitan adolescents drank alcohol, and more than half of each group reported binge drinking. Illicit Drug Use. Prevalence rates for most illicit drugs were similar among non-metropolitan and metropolitan adolescents, with two exceptions. The prevalence of past year methamphetamine use was significantly higher among non-metropolitan than metropolitan adolescents (0.3% vs 0.2%), and the prevalence of past 30-day hallucinogen use was significantly lower among non-metropolitan than metropolitan adolescents (0.2% vs. 0.6%).