title: Heterogeneity of alcohol, tobacco, and other substance use behaviors in U.S. college students: A latent class analysis.
abstract: OBJECTIVE
  To identify subgroups of college students with distinct profiles of traditional and alternative types of tobacco, alcohol, and other substance use and to examine how demographic characteristics and academic and social activities are associated with subgroup membership.
  
  
  METHODS
  We used latent class analysis to characterize subgroups of individuals in their fourth-year of college based on their patterns of seven substance use behaviors: extreme heavy episodic drinking (HED), cigarette use, cigar/cigarillo/little cigar use, smokeless tobacco use, hookah use, marijuana use, and non-medical prescription drug use. Demographic characteristics and academic and social activities were then incorporated as predictors of these latent classes.
  
  
  RESULTS
  We identified five classes defined by unique behavior patterns: (1) Non/Low Users, (2) Non-Hookah Tobacco Users, (3) Extreme HED & Marijuana Users, (4) Hookah and Marijuana Users, and (5) Poly-Substance Users. Being male, older, and involved in sports were associated with greater odds of being in the Poly-Substance User class compared to the Low/No User class, and participating in an honors society and reporting more positive peer relationships were associated with being in the Hookah and Marijuana User class compared to the Low/No User class.
  
  
  CONCLUSIONS
  Our findings of unique characteristics in the subgroups identified suggest that college substance users are a heterogeneous population requiring different targeted interventions. Of particular concern are subgroups with high rates of alternative tobacco products, as perceived risks of use may be inaccurate and this is not currently a focus of college substance use prevention interventions.
authors.affiliation: The Methodology Center and Prevention Research Center, Pennsylvania State University, University Park, PA, United States. Electronic address: revanspolce@psu.edu.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Evans-Polce
authors.affiliation: The Methodology Center and Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, United States.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lanza
authors.affiliation: Department of Human Development and Family Studies and Prevention Research Center, Pennsylvania State University, University Park, PA, United States.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Maggs
mesh_terms: D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology* / Q000523:psychology; D010379:Peer Group; D063487:Prescription Drug Misuse / Q000523:psychology / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D013177:Sports / Q000523:psychology / Q000706:statistics & numerical data; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014495:Universities; D055815:Young Adult
keywords: Alternative tobacco products; College students; Heavy episodic drinking, cigarette use; Substance use