Skip to main content

Advertisement

Log in

Longitudinal Patterns of Multiple Tobacco and Nicotine Product Use Among Texas College Students: a Latent Transition Analysis

  • Published:
Prevention Science Aims and scope Submit manuscript

Abstract

Diverse tobacco and nicotine products have altered the terrain of tobacco use behaviors. Limited research has examined contemporary patterns of use among young adults. This study identified tobacco and nicotine product use groups and examined changes in young adults’ use patterns, across a 1.5-year period. Participants were 5,482 18–29-year-old students (M age = 20.5, SD = 2.36; 63% female) from 24 Texas colleges who completed a four-wave bi-annual online survey. Latent transition analysis was used to identify groups from 10 items (ever and current use of cigarettes, cigars, smokeless tobacco, e-cigarettes, and hookah) and to examine probabilities of transitioning between groups over four waves. Five groups were identified: Non-users (30%), Poly-experimenters (26%), Hookah experimenters (18%), E-cigarette & hookah experimenters (15%), and Poly-cigarette users (11%). Few students transitioned between groups over time. Poly-cigarette users had the highest average probability of remaining stable over time (1.00), followed by E-cigarette & hookah experimenters (.97), Non-users (.94), Poly-experimenters (.93), and Hookah experimenters (.92). All groups became more stable over time except Hookah experimenters whose members were most likely to transition to Poly-cigarette users or other experimenter groups. The greatest transition was from Poly-experimenters to Poly-cigarette users with probabilities of .10, .08, and .03 for transitioning between waves one and two, two and three, and three and four, respectively. There was substantial poly-use and experimentation, which may explain little movement between groups over the 1.5-year time period and underscores the need for prevention programs targeting multiple product use among college students.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Barrington-Trimis, J. L., Urman, R., Berhane, K., Unger, J. B., Cruz, T. B., Pentz, M. A., ..., McConnell, R. (2016). E-cigarettes and future cigarette use. Pediatrics, 138(1).

  • Berg, C. J., Haardöerfer, R., Escoffery, C., Zheng, P., & Kegler, M. (2014). Cigarette users’ interest in using or switching to electronic nicotine delivery systems for smokeless tobacco for harm reduction, cessation, or novelty: A cross-sectional survey of US adults. Nicotine & Tobacco Research, 17, 245–255.

    Article  Google Scholar 

  • Biener, L., McCausland, K., Curry, L., & Cullen, J. (2011). Prevalence of trial of snus products among adult smokers. American Journal of Public Health, 101, 1874–1876.

    Article  PubMed  PubMed Central  Google Scholar 

  • Choi, H. J., Yu, M., & Sacco, P. (2018). Racial and ethnic differences in patterns of adolescent tobacco users: A latent class analysis. Children and Youth Services Review, 84, 86–93.

    Article  Google Scholar 

  • Collins, L. M., & Lanza, S. T. (2013). Latent class and latent transition analysis: With applications in the social, behavioral, and health sciences (Vol. 718): John Wiley & Sons.

  • Delk, J., Carey, F. R., Case, K. R., Creamer, M. R., Wilkinson, A. V., Perry, C. L., & Harrell, M. B. (2019). Adolescent tobacco uptake and other substance use: A latent class analysis. American Journal of Health Behavior, 43, 3–14.

    Article  PubMed  Google Scholar 

  • Haardörfer, R., Berg, C. J., Lewis, M., Payne, J., Pillai, D., McDonald, B., & Windle, M. (2016). Polytobacco, marijuana, and alcohol use patterns in college students: A latent class analysis. Addictive Behaviors, 59, 58–64.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hinds III, J. T., Loukas, A., Chow, S., Pasch, K. E., Harrell, M. B., Perry, C. L., . . . Wackowski, O. A. (2016). Using cognitive interviewing to better assess young adult e-cigarette use. Nicotine & Tobacco Research, 18, 1998–2005.

  • Hu, S. S. (2016). Tobacco product use among adults—United States, 2013–2014. MMWR. Morbidity and Mortality Weekly Report, 65, 685–691.

    Article  PubMed  Google Scholar 

  • Huh, J., & Leventhal, A. M. (2016). Progression of poly-tobacco product use patterns in adolescents. American Journal of Preventive Medicine, 51(4), 513–517.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kasza, K. A., Ambrose, B. K., Conway, K. P., Borek, N., Taylor, K., Goniewicz, M. L., ..., & Kaufman, A. R. (2017). Tobacco-product use by adults and youths in the United States in 2013 and 2014. New England Journal of Medicine, 376, 342–353.

  • Kypriotakis, G., Robinson, J. D., Green, C. E., & Cinciripini, P. M. (2018). Patterns of tobacco product use and correlates among adults in the Population Assessment of Tobacco and Health (PATH) study: A latent class analysis. Nicotine & Tobacco Research, 20, S81–S87.

    Article  Google Scholar 

  • Lantz, P. M., Jacobson, P. D., Warner, K. E., Wasserman, J., Pollack, H. A., Berson, J., & Ahlstrom, A. (2000). Investing in youth tobacco control: A review of smoking prevention and control strategies. Tobacco Control, 9, 47–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lanza, S. T., Dziak, J. J., Huang, L., Wagner, A., & Collins, L. M. (2015). PROC LCA & PROC LTA user’s guide (version 1.3. 2). University Park: The Methodology Center, Penn State. Retrieved October 1, 2017, from http://methodology.psu.edu.

  • Lisha, N. E., Thrul, J., & Ling, P. M. (2019). Latent class analysis to examine patterns of smoking and other tobacco products in young adult Bar patrons. Journal of Adolescent Health, 64, 93–98.

    Article  PubMed  Google Scholar 

  • Loukas, A., Murphy, J. L., & Gottlieb, N. H. (2008). Cigarette smoking and cessation among trade or technical school students in Texas. Journal of American College Health, 56, 401–407.

    Article  PubMed  Google Scholar 

  • Loukas, A., Batanova, M., Fernandez, A., & Agarwal, D. (2015). Changes in use of cigarettes and non-cigarette alternative products among college students. Addictive Behaviors, 49, 46–51.

    Article  PubMed  Google Scholar 

  • Loukas, A., Chow, S., Pasch, K. E., Li, X., Hinds, I., Josephine, T., ..., Perry, C. L. (2016). College students’ polytobacco use, cigarette cessation, and dependence. American Journal of Health Behavior, 40, 514–522.

  • Loukas, A., Marti, C. N., Cooper, M., Pasch, K. E., & Perry, C. L. (2018). Exclusive e-cigarette use predicts cigarette initiation among college students. Addictive Behaviors, 76, 343–347.

    Article  PubMed  Google Scholar 

  • Loukas, A., Marti, C. N., & Perry, C. L. (2019). Trajectories of tobacco and nicotine use across young adulthood, Texas, 2014–2017. American Journal of Public Health, 109, 465–471 (0), e1-e7.

    Article  PubMed  Google Scholar 

  • Osibogun, O., Jaber, R., Bahelah, R., Taleb, Z. B., & Maziak, W. (2017). Poly-tobacco use among young adults in the United States: Findings from the Population Assessment on Tobacco and Health study, 2013–2014. Annals of Epidemiology, 27, 535.

    Article  Google Scholar 

  • Perry, C. L., Pérez, A., Bluestein, M., Garza, N., Obinwa, U., Jackson, C., et al. (2018). Youth or young adults: Which group is at highest risk for tobacco use onset? The Journal of Adolescent Health, 63, 413–420.

    Article  PubMed  PubMed Central  Google Scholar 

  • Primack, B. A., Shensa, A., Escobar-Viera, C. G., Barrett, E. L., Sidani, J. E., Colditz, J. B., & James, A. E. (2017). Use of multiple social media platforms and symptoms of depression and anxiety: A nationally-representative study among US young adults. Computers in Human Behavior, 69, 1–9.

    Article  Google Scholar 

  • PROC LCA & PROC LTA (Version 1.3.2) [software]. (2015). Univeristy Park: The Methodology Center, Penn State. http://methodology.psu.edu. Accessed 1 Oct 2017.

  • Simon, P., Camenga, D. R., Kong, G., Connell, C. M., Morean, M. E., Cavallo, D. A., & Krishnan-Sarin, S. (2017). Youth e-cigarette, blunt, and other tobacco use profiles: Does SES matter? Tobacco Regulatory Science, 3, 115–127.

    Article  PubMed  PubMed Central  Google Scholar 

  • Soneji, S., Barrington-Trimis, J. L., Wills, T. A., Leventhal, A. M., Unger, J. B., Gibson, L. A., ..., Miech, R. A. (2017). Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults: A systematic review and meta-analysis. JAMA Pediatrics, 171, 788–797.

  • Thompson, A. B., Mowery, P. D., Tebes, J. K., & McKee, S. A. (2017). Time trends in smoking onset by sex and race/ethnicity among adolescents and young adults: Findings from the 2006–2013 National Survey on Drug Use and Health. Nicotine & Tobacco Research, 20, 312–320 ntx010.

    Article  Google Scholar 

  • Tomczyk, S., Isensee, B., & Hanewinkel, R. (2016). Latent classes of polysubstance use among adolescents—A systematic review. Drug and Alcohol Dependence, 160, 12–29.

    Article  PubMed  Google Scholar 

  • U.S. Bureau of Labor Statistics. (2017). 69.7% of 2016 high school graduates enrolled in college in October 2016. https://www.bls.gov/opub/ted/2017/69-point-7-percent-of-2016-high-school-graduates-enrolled-in-college-in-october-2016.htm. Accessed 28 Feb 2019.

  • U.S. Department of Health and Human Services. (2004). The health consequences of smoking: A report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 62.

  • U.S. Department of Health and Human Services. (2012). Preventing tobacco use among youth and young adults: A report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 3.

  • U.S. Department of Health and Human Services. (2016). E-cigarette use among youth and young adults: A report of the Surgeon General . Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

  • U.S. Food and Drug Administration. (2017). Research priorities. Retrieved August 18, 2018, from https://www.fda.gov/TobaccoProducts/PublicHealthScienceResearch/Research/ucm311860.htm.

  • Velazquez, C. E., Pasch, K. E., Laska, M. N., Lust, K., Story, M., & Ehlinger, E. P. (2011). Differential prevalence of alcohol use among 2-year and 4-year college students. Addictive Behaviors, 36, 1353–1356.

    Article  PubMed  PubMed Central  Google Scholar 

  • Villanti, A. C., Niaura, R. S., Abrams, D. B., & Mermelstein, R. (2018). Preventing smoking progression in young adults: The concept of prevescalation. Prevention Science, 20, 377–384 1–8.

    Article  Google Scholar 

  • Willis, G. B. (2004). Cognitive interviewing: A tool for improving questionnaire design. Sage Publications.

  • Windle, M. (2003). Alcohol use among adolescents and young adults. Population, 45, 19–15.

    Google Scholar 

  • Yu, E. S., Saddleson, M. L., Murphy, J. M., Giovino, G. A., & Mahoney, M. C. (2017). Patterns of polytobacco use among college students. Health Behavior and Policy Review, 4, 173–181.

    Article  Google Scholar 

  • Yu, M., Sacco, P., Choi, H. J., & Wintemberg, J. (2018). Identifying patterns of tobacco use among US middle and high school students: A latent class analysis. Addictive Behaviors, 79, 1–7.

    Article  PubMed  Google Scholar 

Download references

Funding

Research reported in this presentation was supported by grant number (1 P50 CA180906) from the National Cancer Institute and the FDA Center for Tobacco Products (CTP).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephanie L. Clendennen.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Clendennen, S.L., Loukas, A., Creamer, M.R. et al. Longitudinal Patterns of Multiple Tobacco and Nicotine Product Use Among Texas College Students: a Latent Transition Analysis. Prev Sci 20, 1031–1042 (2019). https://doi.org/10.1007/s11121-019-01031-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11121-019-01031-3

Keywords

Navigation