Problem/Objective: Studies found that the prevalence of current smoking among adults was higher in rural counties than in urban counties in Florida. Although smoking prevalence among youth has declined in Florida, youth smoking rate varies greatly among sub-populations. Little is known about the geographic variation of youth smoking rate. The purpose f this study is to assess geographic variations of current smoking prevalence among middle and high school students in Florida.

Methods: This study analyzed the 2006 Florida Youth Tobacco Survey data. Counties were defined as urban, rural or semi-urban based on the Beale codes. Bi-variable and multi-variable analyses were performed to assess the geographic variations of youth current smoking rate. Race, ethnicity, age, sex, and receiving tobacco prevention education were controlled in the analyses.

Results: 66,437 middle and high school students from 65 counties responded the 2006 survey. County level current smoking prevalence ranged from 2.3% to 20.1% among middle school students, and from 7.6% to 32.1% among high school students. All rural counties, except one, had prevalence higher than the state average. The rural counties had a prevalence of current smoking 4% higher than that in urban counties (p<0.01), controlling for sex, race, ethnicity and receiving tobacco prevention education.

Conclusions: Students in rural counties are likely to have a higher prevalence rate than their counterparts in urban counties. The pattern was similar to that among adults in Florida. The results of this study may be used for better planning tobacco prevention programs among youth.