Latent class trajectories: U.S. adolescents' nicotine use and its association with nicotine dependence

Carol J Boyd; Philip Veliz; Rebecca Evans-Polce; Andria B Eisman; Sean Esteban McCabe

doi:10.1016/j.abrep.2020.100303

Latent class trajectories: U.S. adolescents' nicotine use and its association with nicotine dependence

Addict Behav Rep. 2020 Sep 9:12:100303. doi: 10.1016/j.abrep.2020.100303. eCollection 2020 Dec.

Authors

Carol J Boyd^{1

2

3}, Philip Veliz^{1

2}, Rebecca Evans-Polce^{1

2}, Andria B Eisman⁴, Sean Esteban McCabe^{1

2

5}

Affiliations

¹ Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, 400 North Ingalls Street, Ann Arbor, MI 48109, USA.
² School of Nursing, University of Michigan, 400 North Ingalls Street, Ann Arbor, MI 48109, USA.
³ Addiction Center, Department of Psychiatry, Rachel Upjohn Bldg, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
⁴ Division of Kinesiology, Health and Sport Studies, College of Education, Wayne State University, 656 West Kirby, Detroit, MI 48202, USA.
⁵ Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI 48104, USA.

Abstract

Introduction: Twenty-seven percent of adolescents used a nicotine/tobacco product in 2018. Our study analyzed three waves from the Population Assessment of Tobacco and Health (PATH) Study and examined adolescent nicotine/tobacco use trajectories over time to determine which latent classes were associated with symptoms of nicotine dependence.

Methods: The PATH Study used a four-stage, stratified area probability sample and annual household interviews with adolescents (12-17 years). Adolescents who indicated past 30-day nicotine/tobacco use at least once were included (n = 1101). We used latent class analysis (LCA) to identify nicotine/tobacco trajectories across three waves of PATH data and their association with six symptoms consistent with nicotine dependence from the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68).

Results: All types of past 30-day nicotine/tobacco use increased across the three waves. An LCA model fit was assessed using both the CIV and entropy measures in conjunction with the Vuong-Lo-Mendell-Rubin LRT. A five latent class solution had the lowest BIC value (BIC = 9784.272), and resulted in: (1) "Stable/consistent multiproduct use trajectory", (2) "Increasing cigarette use trajectory", (3) "Increasing e-cigarette use trajectory", (4) "Experimental (poly-nicotine/tobacco) use trajectory", and (5) "Increasing other nicotine/tobacco use trajectory". The most prevalent was the "Experimental (poly-nicotine/tobacco) use trajectory" (33.8%) although sex, race, and social class were associated with different trajectories. Those represented by the "Increasing cigarette use trajectory" (19.4%) reported significantly more past-year nicotine dependence symptoms (b = 1.73, p < 0.001) compared to the "Increasing e-cigarette use trajectory". Findings varied by sex and race.

Conclusions: Results indicate that the relationship between e-cigarette use and other forms of nicotine/tobacco and substance use is complex and that adolescent nicotine/tobacco users are a heterogenous group with different risks for nicotine dependence. Findings can inform tailored prevention education and messaging for different groups of youth.

Keywords: Adolescent nicotine/tobacco use trajectories; BIC, Bayesian information criterion; Cigarette use; E-cigarettes; GEE, generalized estimating equations; LCA, latent class analysis; LRT, likelihood ratio test; NYTS, National Youth Tobacco Survey; PATH Study, Population Assessment of Tobacco and Health Study; SD, standard deviation; WISDM-68, Wisconsin Inventory of Smoking Dependence Motives.

Grants and funding

R01 DA044157/DA/NIDA NIH HHS/United States