Introduction. Anti-health behaviours pose a threat to the health status of the adolescent population in Poland. Among other things, the use and abuse of tobacco, alcohol and psychoactive substances are very dangerous as they may give rise to further health inequalities in young people. The aim of the research was to compare scopes of anti-health behaviours of adolescents in rural and urban areas in Poland. Material and methods. The study consisted of 1,580 adolescents (aged 15-19 years) – 596 from urban areas and 984 from rural areas of the Zachodniopomorskie Province in Poland. Results. 25.61% of 15-19-year-old city dwellers and 30.57% of their rural peers are active tobacco smokers. The smoking habit is more popular among female adolescents than among their male peers.4.64% of rural 15-19-year-olds, and 4.52% of their city peers, are addicted to narcotics, 11.16% of the surveyed rural adolescents and 6.7% of their peers living in urban areas are addicted to alcohol. More than 50% of adolescents drink alcohol occasionally. Conclusions. A significant number of young people in both rural and urban areas are engaged in risky health behaviours. The frequency of such behaviours depends on the age, gender and place of residence. These disproportions may contribute to future health inequalities in rural and urban areas.