Repeated measures latent class analysis of daily smoking in three smoking cessation studies

Abstract

Background: Person-centered approaches to the study of behavior change, such as repeated measures latent class analysis (RMLCA), can be used to identify patterns of change and link these to later behavior change outcomes.

Methods: Daily smoking status data from three smoking cessation studies (N=287, N=334, and N=403) were submitted to RMLCA to identify latent classes of smokers based on patterns of abstinence across the first 27days of a quit attempt. Three-month biochemically verified abstinence rates were compared among latent classes with particular patterns of smoking across days. Pharmacotherapy variables and baseline individual differences were added as covariates of latent class membership.

Results: Results of separate and pooled analyses supported a five-class solution that replicated across studies. Latent classes included a large class that achieved immediate stable abstinence, a smaller class of cessation failures, and three classes with partial abstinence that increased, decreased, or remained stable over time. Three-month point-prevalence abstinence rates varied among the latent classes, with 38-55% abstinent among early quitters, 3-20% abstinent among those who smoked intermittently throughout the first 27days, and fewer than 5% abstinent in the classes marked by little or delayed change in smoking. High-dose nicotine patch and bupropion promoted membership in abstinent classes. Demographics, nicotine dependence, and craving were related to latent class in multiple studies and pooled analyses.

Conclusions: We identified five patterns of smoking behavior in the first weeks of a smoking cessation attempt. These patterns are robust across multiple studies and are related to later point-prevalence abstinence rates.

Keywords: Cessation; Repeated measures latent class analysis; Smoking; Tobacco.