Date of Publication

2025

Faculty Mentor

Dr. Sarah Nowak

Abstract

Association of Substance Use with Poor Mental Health in Urban and Rural Vermont Communities

Samantha Collins, BS; Raiel Barlow, MD; Eileen Brickell, BS; Olivia White, BS; Urmila Chhetri, BA; Thomas Delaney, PhD; Elzerie de Jager, MBBS, PhD; Sarah Nowak, PhD

The University of Vermont Larner College of Medicine

Objectives. To examine the difference in association between heavy alcohol consumption and tobacco use with self-reported poor mental health, stratified by rurality in Vermont.

Methods. A weighted cross-sectional study was conducted on adult residents (n = 344,837) of Vermont using data obtained from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). Using the Method of Best Selection, successive logistic regression models were run to investigate the association between heavy alcohol and tobacco use with poor mental health, accounting for demographic and known confounders such as transportation, food, and income insecurities, stress, and general health in rural and urban cohorts.

Results. In urban regions, smokers had higher odds of poor mental health compared to non-smokers, while drinking was not statistically significant (smokers OR, 1.2542, [95% CI, 1.012, 1.55] P< 0.05; drinking OR, 1.33 [95% CI, 0.919, 1.915] P=0.131) (Table 1). Neither smoking nor drinking in rural populations showed a significant relationship with poor mental health (smokers OR, 1.18 [95% CI, 0.84,1.36] P= 0.31; drinking OR, 1.280, [95% CI, 0.817, 2.01] P=0.281) (Table 1). However, there was an associated decrease in the odds of poor mental health with increasing age (Table 1). Finally, participants who reported “always being stressed” showed the highest odds of poor mental health compared to their “never stressed” counterparts (Table 1).

Conclusion. The correlation between tobacco use and mental health in urban counties has implications for public health, with prior research supporting these findings. Further research is recommended into recent trends to corroborate robustness of findings in the association between substance use and mental health, as well as to consider other mitigating factors in both rural and urban areas.

Document Type

Project

Available for download on Sunday, April 25, 2027

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