Using latent class analysis to examine susceptibility to various tobacco products among adolescents.

Abstract

INTRODUCTION\nMost tobacco use is initiated during adolescence and susceptibility is an important predictor of initiation. Research is needed to understand susceptibility across tobacco products among youth to inform prevention efforts.\n\n\nMETHODS\nWe surveyed 2,945 students from four Southeastern Connecticut high schools in 2017. We assessed susceptibility to future use of 7 different tobacco products (i.e., cigarettes, e-cigarettes, hookah, cigars, cigarillos, blunts, and smokeless tobacco) among youth who had never used a tobacco product. Susceptibility was coded as any response other than definitely not to 3 items assessing 1) curiosity, 2) willingness to experiment with the product in the future, and 3) willingness to try if offered by a friend. Latent class analysis (LCA) was used to identify patterns of susceptibility across multiple tobacco products and socio-demographic predictors of these classes.\n\n\nRESULTS\nAmong n=1246 youth who had never tried a tobacco product, 51.2% (n=638) were susceptible to at least one product and 29.1% (n=363) were susceptible to two or more products (average among susceptible youth: M=2.4 products, SD=1.7, range 1-7). LCA identified 3 classes; youth who were: 1) susceptible to all products (5.6%), 2) susceptible to e-cigarettes, hookah, and blunts (23.6%), and 3) mostly non-susceptible to all products (70.8%). In a multivariable model, demographic variables and peer tobacco use predicted class membership.\n\n\nCONCLUSIONS\nWe observed high rates of susceptibility to non-traditional tobacco products among youth, and many youth were susceptible to more than one product. Targeting susceptibility across multiple tobacco products may be important for reducing youth tobacco use.