Rural and urban substance use differences: Effects of the transition to college.

Background: With approximately 20% of Americans residing in rural communities, substance use differences is an important topic for appropriate use of resources, policy decisions, and the development of prevention and intervention programs.

Objectives: The current study examined differences in alcohol, tobacco, and marijuana use among students from rural and urban backgrounds across the transition to college.

Methods: Participants were 431 (48% male) undergraduate students from a large, public southeastern university who provided yearly alcohol, tobacco, and marijuana use data during freshman, sophomore, and junior years.

Results: Prevalence of alcohol, tobacco, and marijuana use was lower during early college years, and females were less likely to use tobacco and marijuana. Results indicated that rural individuals were less likely to use alcohol and marijuana than their urban counterparts as freshmen, but rose to meet the rates of urban students by junior year. In contrast, no rural/urban differences in tobacco were noted, although rural minorities were more likely to endorse tobacco use across all years. Finally, perceived peer use of each substance was a significant predictor of future use of that substance for all years.

Conclusion: This is the first study to explore rural/urban, gender, and racial differences in substance use across the college transition. Results suggest that there are subgroups of individuals at specific risk who may benefit not only from feedback regarding the influence of perceived peer use in college, but also from a deeper understanding of how cultural norms maintain their substance use behaviors over time.