Family medicine
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Although smoking and smokeless tobacco use are recognized as major problems among school-age youth, few studies report on tobacco use in rural areas, especially remote rural areas. ⋯ The high rate of female smokers and male chewers in senior high is consistent with other studies. The rate of female chewing tobacco use is unusually high. Isolated rural communities have significant adolescent tobacco abuse, and prevention and treatment strategies need to be developed for this special population.