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.
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.
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.
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.
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.
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.
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.
Huh, J., & Leventhal, A. M. (2016). Progression of poly-tobacco product use patterns in adolescents. American Journal of Preventive Medicine, 51(4), 513–517.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Tomczyk, S., Isensee, B., & Hanewinkel, R. (2016). Latent classes of polysubstance use among adolescents—A systematic review. Drug and Alcohol Dependence, 160, 12–29.
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.
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.
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.
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.
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.
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
Corresponding author
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
About this article
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
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11121-019-01031-3