A latent class analysis of nicotine-dependence criteria and use of alternate tobacco.
OBJECTIVE
Prior latent class analyses have identified subgroups of smokers that vary by the severity and individual symptoms of nicotine dependence. These analyses have not accounted for the use of alternate tobacco, which is most prevalent among current cigarette smokers. The objective of this study was to determine whether smokers who frequently use other forms of tobacco constitute a latent class characteristic of nicotine-dependence symptoms.


METHODS
Current cigarette smokers (N=4,517), who had a lifetime history of daily smoking, were selected from Wave III of the National Longitudinal Study of Adolescent Health. A latent class model was based on 10 indicators, which included 6 items from the Fagerstrom Test for Nicotine Dependence and 4 measures of the past-month use of tobacco products (cigarettes, cigars, smokeless tobacco, bidis). Covariates included demographic, psychosocial, smoking-related characteristics, and the use of other substances.


RESULTS
One of the five estimated latent classes, which ranked second in severity of nicotine dependence only to the class with the heaviest smokers, consisted of light-to-medium smokers who were the most frequent users of alternate tobacco.


CONCLUSIONS
Alternate tobacco use is correlated with nicotine dependence among smokers, a factor that should be considered in promoting the substitution of one tobacco product for another.
Timberlake
David S
DS
Program in Public Health, College of Health Sciences, University of California, Irvine, 100 Theory, Suite 100, Irvine, California 92697, USA. dtimberl@uci.edu
D000293:Adolescent; D000328:Adult; D003625:Data Collection; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015233:Models, Statistical; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology*; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014030:Tobacco, Smokeless