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Study identifies distinct trajectories, risk factors for initiating cigarette use during and after college

A new study used socioecological theory to examine cigarette smoking trajectories among U.S. young adults. As part of a larger study, participants from aged 18 to 25 years old were recruited from multiple colleges in Georgia (a state with few tobacco control measures). The study consisted of six waves of data collection via online survey self-report across a two-year period; retention across waves exceeded 70%. Only participants who reported data on their cigarette use beyond Wave 1 were included in this analysis (n = 2,967). Survey measures included individual-, interpersonal-, and community-level factors. At the individual level, participants reported their lifetime use, past-four-month use, and age at first use of cigarettes, other tobacco products, and other substances, depressive symptoms experienced in the past six months, and sociodemographic characteristics. Interpersonal-level factors assessed included adverse childhood experiences, social support, and parental tobacco and marijuana use. Community-level factors assessed were type of school (private, public, HBCU, technical college) and location (urban vs. rural). The authors used grow mixture modeling to analyze cigarette use across Waves 2 – 6 and identify trajectories. Next, multinomial logistic regressions were employed to assess the relationships between cigarette use trajectory class and participant characteristics. Results indicated the sample was 64.5% female, 22.6%, and had a mean age of 20.54 years (standard deviation [SD] = 1.94). Three trajectory classes were identified: Abstainers/Dabblers (those who reported ever using cigarettes once or never; 85.65), college onset smokers (6.2%), and later smokers (those who began using cigarettes during their mid-to-late twenties; 8.2%). From age 19 to 27, the overall probability of cigarette use declined from about 16.3% to 2.5%. Results of the multinomial regressions identified being male (p = 0.031), being Asian (p = 0.001), initiating cigarette use before age 15 years (p = 0.006), past-month use of little cigars/cigarillos (p = 0.024), past-month alcohol use (p < 0.001), and past-month marijuana use (p = 0.008) as individual-level predictors of being college onset smokers, relative to abstainers/dabblers. At the interpersonal and community levels, predictors included attending a public (p = 0.031) or technical college (p < 0.001), compared to a private institution. Predictors of belonging to the later onset smokers class including being male (p = 0.019) and attending a technical (p = 0.005) versus private college.

Take away: Using a sample of college students from multiple types of institutions, this study identified three trajectory classes for cigarette use: Abstainers/Dabblers, college onset smokers, and late onset smokers. The authors also examined individual-, interpersonal, and community-level predictors of trajectory class membership.

Berg, C.J., Haardörfer, R., Vu, M., Getachew, B., Lloyd, S.A., Lanier, A., Childs, D., Sandridge, Y., Bierhoff, J., Li, J., Dossantos, E. & Windle, M.  (2018). Cigarette use trajectories in young adults: Analyses of predictors across system levels. Drug and Alcohol Dependence, 188, 281-287. doi: 10.1016/j.drugalcdep.2018.03.055

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