Cigarette Smoking Trajectories From Sixth to Twelfth Grade: Associated Substance Use and High School Dropout.
BACKGROUND
The purpose of this longitudinal study was to identify distinct trajectories of cigarette smoking from sixth to twelfth grade and to characterize these trajectories by use of other drugs and high school dropout.


METHODS
The diverse sample for this analysis consisted of a cohort of 611 students from Northeast Georgia who participated in the Healthy Teens Longitudinal Study (2003-2009). Students completed seven yearly assessments from sixth through twelfth grade. We used semi-parametric, group-based modeling to identify groups of students whose smoking behavior followed a similar progression over time.


RESULTS
Current smoking (past 30 day) increased from 6.9% among sixth graders to 28.8% among twelfth graders. Four developmental trajectories of cigarette smoking were identified: Abstainers/Sporadic Users (71.5% of the sample), Late Starters (11.3%), Experimenters (9.0%), and Continuous Users (8.2%). The Abstainer/Sporadic User trajectory was composed of two distinct groups: those who never reported any tobacco use (True Abstainers) and those who reported sporadic, low-level use (Sporadic Users). The True Abstainers reported significantly less use of alcohol and other drugs and lower dropout rates than students in all other trajectories, and Sporadic Users had worse outcomes than True Abstainers. Experimenters and Continuous Users reported the highest drug use. Over one-third of Late Starters (35.8%) and almost half of Continuous Users (44.4%) dropped out of high school.


CONCLUSIONS
Cigarette smoking was associated with behavioral and academic problems. Results support early and continuous interventions to reduce use of tobacco and other drugs and prevent high school dropout.
Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA; porpinas@uga.edu.
Pamela
P
Orpinas
Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA;
Beth
B
Lacy
Kinesiology and Health Studies, Southeastern Louisiana University, Hammond, LA;
Lusine
L
Nahapetyan
Division of Epidemiology and Biostatistics, Georgia State University, Atlanta, GA;
Shanta R
SR
Dube
Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA.
Xiao
X
Song
D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012574:Schools / Q000639:trends*; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology / Q000639:trends*; D013332:Student Dropouts / Q000523:psychology; D013334:Students / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*