Neighborhood Disadvantage and Adolescent Substance Use: Differences by Urbanicity and Substance Type

OBJECTIVE: We examined associations between neighborhood socioeconomic context and substance use among U.S. adolescents using nationally representative samples. We further tested whether these associations differed by urbanicity. METHODS: graders in 2016-2019 from the Monitoring the Future (MTF) study (n=54,108). Neighborhood socioeconomic context was measured by a disadvantage index in the zipcode of the schools MTF respondents attended, using data on residents' economic status (income, public assistance, poverty) from the American Community Survey. Outcomes included past 30-day cigarette use, past 2-week binge drinking, and past 30-day cannabis use. Survey-weighted logistic models estimated associations between neighborhood disadvantage and the use of each substance, as well as interactions of the associations by urbanicity (urban, suburban, rural). RESULTS: Neighborhood disadvantage was positively associated with adolescent cigarette use but inversely associated with binge drinking. After controlling for individual-level socioeconomic characteristics, the association between neighborhood disadvantage and adolescent binge drinking became non-significant. The associations of neighborhood disadvantage with cigarette use differed by urbanicity. In rural areas, adolescent cigarette use increased with greater neighborhood disadvantage, which was not observed in urban areas. No significant interaction effects were found for binge drinking and cannabis use. CONCLUSIONS: We found a complex interplay between neighborhood socioeconomic context and adolescent substance use, with patterns varying by both urbanicity and substance. This suggests the potential for tailored prevention and intervention efforts for adolescent substance use in particular neighborhood contexts.