Place-based risk: Examining relationships between adolescent perceptions of community risk factors and adolescent substance use across geographic contexts.

Mixed evidence for the influence of structural and social factors on adolescent substance use behaviors exists across the rural-urban continuum. Therefore, this study explores how adolescent perceptions of structural and social community risk factors are associated with lifetime and past 30-day use of alcohol, marijuana, cigarettes, and illicit drugs among adolescents in different geographic locations. Data from 9819 adolescents from the 2019 Florida Youth Substance Abuse Survey were used to estimate associations between adolescent perceptions of community risk factors and lifetime and past 30-day alcohol, marijuana, cigarette, and illicit drugs using logistic regression models stratified by geographic location. Adolescent perceptions of community disorganization were significantly associated with lifetime and past 30-day alcohol use among town and rural adolescents and illicit drug use among adolescents from all geographic locations. Findings point to shared and unique risk and protective processes in geographic locations with implications for future research and community prevention efforts.