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Original Research

Adolescent daily cigarette smoking: is rural residency a risk factor?

Submitted: 14 October 2007
Revised: 19 January 2008
Published: 26 March 2008

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Author(s) : Lutfiyya M, Shah KK, Johnson M, Bales RW, Cha I, McGrath C, Serpa L, Lipsky MS.

May Nawal LutfiyyaKunal ShahMark JohnsonRobert BalesIsaac ChaCynthia McGrathMartin Lipsky

Citation: Lutfiyya M, Shah KK, Johnson M, Bales RW, Cha I, McGrath C, Serpa L, Lipsky MS.  Adolescent daily cigarette smoking: is rural residency a risk factor? Rural and Remote Health (Internet) 2008; 8: 875. Available: (Accessed 20 October 2017)


Introduction:  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. Purpose: 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.

Key words:  adolescent tobacco use, rural youth tobacco use, Youth Risk Behavior Surveillance System.

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