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> drug/stimulant use (YOLO culture?) [...] The interesting statistic was the urban regions were less pronounced than the suburbs, which may indicate something either cultural or economic that may drive this change.

"Energy drinks" (Red Bull, Monster, Rockstar et. al.) blew up in the late '90s/early 2000s or so. As far as I remember, early marketing for these was heavily targeted at "extreme sports" fans and practitioners of their less-extreme variants (e.g. skateboarding). I wonder if that targeting might have something to do with the urban/suburban split.