A Centers for Disease Control and Prevention (CDC) report outlines high school students’ substance use behaviors and differences by demographic characteristics and urban/rural classification.

• The data comes from the 2025 Youth Risk Behavior Survey (YRBS).

The findings:

• Overall: The most commonly reported substance use behaviors were lifetime use of electronic vapor products (30.2%) and marijuana (25.5%), followed by current use of alcohol (20.3%) and electronic vapor products (16.0%).
• Sex and Race/Ethnicity: Male students had a higher prevalence than female students of current use of cigarettes, cigars, and smokeless tobacco, as well as lifetime use of cocaine, heroin, and hallucinogenic drugs. But female students had a higher prevalence of current and lifetime use of vape products and prescription opioid misuse, as well as lifetime marijuana use. Racial/ethnic differences varied by substance.
• Age: Most grade-related differences reflected higher prevalence among students in higher grade levels.
• Rural/urban: Students in rural public schools had a higher prevalence of current smokeless tobacco and current and lifetime vape product use than students in city and suburb/town public schools, as well as a higher prevalence of current cigarette and cigar use than students in suburb/town schools.

The main point: Findings suggest that alcohol, marijuana, and vape product use remain common among high school students. Students attending rural schools had a higher prevalence of several tobacco-related behaviors than students in city and suburb/town schools.

• Why it’s important: The findings can guide youth substance use prevention programs, including tobacco and nicotine prevention strategies tailored to rural schools and communities.