title: Paths to tobacco abstinence: A repeated-measures latent class analysis.
abstract: OBJECTIVE
  Knowledge of smoking change processes may be enhanced by identifying pathways to stable abstinence. We sought to identify latent classes of smokers based on their day-to-day smoking status in the first weeks of a cessation attempt. We examined treatment effects on class membership and compared classes on baseline individual differences and 6-month abstinence rates.
  
  
  METHODS
  In this secondary analysis of a double-blind randomized placebo-controlled clinical trial (N = 1,433) of 5 smoking cessation pharmacotherapies (nicotine patch, nicotine lozenge, bupropion SR, patch and lozenge, or bupropion SR and lozenge), we conducted repeated-measures latent class analysis of daily smoking status (any smoking vs. none) for the first 27 days of a quit attempt. Treatment and covariate relations with latent class membership were examined. Distal outcome analysis compared confirmed 6-month abstinence rates among the latent classes.
  
  
  RESULTS
  A 5-class solution was selected. Three-quarters of smokers were in stable smoking or abstinent classes, but 25% were in classes with unstable abstinence probabilities over time. Active treatment (compared to placebo), and particularly the patch and lozenge combination, promoted early quitting. Latent classes differed in 6-month abstinence rates and on several baseline variables, including nicotine dependence, quitting history, self-efficacy, sleep disturbance, and minority status.
  
  
  CONCLUSIONS
  Repeated-measures latent class analysis identified latent classes of smoking change patterns affected by treatment, related to known risk factors, and predictive of distal outcomes. Tracking behavior early in a change attempt may identify prognostic patterns of change and facilitate adaptive treatment planning.
authors: Department of Psychology, Rutgers, The State University of New Jersey.
authors: Danielle E
authors: DE
authors: McCarthy
authors: Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey.
authors: Lemma
authors: L
authors: Ebssa
authors: Department of Psychology, University of New Mexico.
authors: Katie
authors: K
authors: Witkiewitz
authors: Department of Psychology, University of Pittsburgh.
authors: Saul
authors: S
authors: Shiffman
mesh_terms: D000328:Adult; D016642:Bupropion / Q000008:administration & dosage*; D018765:Dopamine Uptake Inhibitors / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000008:administration & dosage*; D018722:Nicotinic Agonists / Q000008:administration & dosage; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D018765:Dopamine Uptake Inhibitors; D018722:Nicotinic Agonists; D016642:Bupropion; D009538:Nicotine