Warren Jacob C, Smalley K Bryant, Barefoot K Nikki
Mercer University School of Medicine, Macon, Georgia, USA.
Georgia Southern University, Statesboro, Georgia, USA.
Rural Remote Health. 2015 Oct-Dec;15(4):3397. Epub 2015 Oct 31.
Ease of access to substances has been shown to have a direct and significant relationship with substance use for school-aged children. Previous research involving rural samples of middle and high school students reveals that perceived ease of access to substances is a significant predictor of recent use among rural adolescents; however, it is unclear if perceived access to substances varies between rural and urban areas. The purpose of the present study was to examine rural-urban differences in perceived ease of access to alcohol, smoking and chewing tobacco, marijuana, and seven other substances in the US state of Georgia in order to better inform and promote future substance use prevention and programming efforts in rural areas.
Data were analyzed from the 2013 Georgia Student Health Survey II, administered in all public and interested private/charter schools in the state of Georgia. A total of 513 909 students (18.2% rural) indicated their perceived ease of access to 11 substances on a four-point Likert-type scale. Rural-urban differences were investigated using χ2 analysis.
In general, it appeared the rural-urban differences fell along legal/illicit lines. For middle school students, a significant difference in perceived ease of access was found for each substance, with rural students reporting greater access to smoking tobacco, chewing tobacco, and steroids, and urban students reporting greater access to alcohol, marijuana, cocaine, inhalants, ecstasy, methamphetamine, hallucinogens, and prescription drugs. Rural high school students reported higher access to alcohol, smoking tobacco, chewing tobacco, and steroids, with urban students reporting higher access to marijuana, cocaine, inhalants, ecstasy, and hallucinogens. Perceptions of ease of access more than doubled for each substance in both geographies between middle and high school.
The present study found multiple and fairly consistent differences between rural and urban students' perceived ease of access to a variety of substances, with rural students reporting higher levels of access to legal substances and urban students reporting higher levels of access predominantly to illicit substances. Most troubling were the high levels of perceived access to substances, particularly among high school students. Even within rural students who reported lower ease of access, more than half of students reported having at least somewhat easy access to marijuana. More than 60% of both rural and urban high school students reported easy access to alcohol. Future research should investigate ways to decrease the perceptions of access to substances in order to prevent use and abuse.
研究表明，物质的易获取性与学龄儿童的物质使用之间存在直接且显著的关系。此前针对农村地区中学生和高中生样本的研究显示，感知到的物质易获取性是农村青少年近期物质使用情况的一个重要预测指标；然而，目前尚不清楚农村和城市地区在感知到的物质获取便利性方面是否存在差异。本研究的目的是调查美国佐治亚州农村和城市地区在感知到的酒精、吸烟、嚼烟、大麻以及其他七种物质的获取便利性方面的差异，以便为农村地区未来的物质使用预防和规划工作提供更充分的信息并推动相关工作。
对2013年佐治亚州学生健康调查II的数据进行了分析，该调查在佐治亚州所有公立及有意参与的私立/特许学校开展。共有513909名学生（18.2%为农村学生）通过四点李克特量表表明了他们对11种物质获取便利性的感知。通过卡方分析对城乡差异进行了调查。
总体而言，城乡差异似乎遵循合法/非法界限。对于中学生，每种物质在感知到的获取便利性方面都存在显著差异，农村学生报告获取烟草、嚼烟和类固醇的便利性更高，而城市学生报告获取酒精、大麻、可卡因、吸入剂、摇头丸、甲基苯丙胺、致幻剂和处方药的便利性更高。农村高中生报告获取酒精、烟草、嚼烟和类固醇的便利性更高，城市学生报告获取大麻、可卡因、吸入剂、摇头丸和致幻剂的便利性更高。在这两个地区，中学生和高中生对每种物质获取便利性的感知在中学到高中期间都增加了一倍多。
本研究发现农村和城市学生在感知到的多种物质获取便利性方面存在多个且相当一致的差异，农村学生报告获取合法物质的便利性更高，而城市学生报告获取非法物质的便利性更高。最令人担忧的是对物质获取便利性的高感知水平，尤其是在高中生中。即使在报告获取便利性较低的农村学生中，超过一半的学生表示获取大麻至少有些容易。超过60%的农村和城市高中生表示获取酒精很容易。未来的研究应调查如何降低对物质获取便利性的感知，以预防物质的使用和滥用。
