Prevalence of cigarette smoking among rural adolescents in the United States.

Results are reported from a national U.S. study of cigarette smoking carried out from 1996 to 2000 involving 68,270 adolescents. Hierarchical linear modeling was used to model smoking as a function of grade, gender, region, and community size (rurality). Significant effects were found for rurality, region, grade, and gender. The highest levels of smoking were found for rural adolescents, and adolescents living in the South. Males smoked more than females in all regions except the West, where the reverse was true. Given that rural adolescents smoke more "heavily" than do their nonrural peers, researchers must devote more attention to understanding the factors that underlie smoking initiation in rural youth.