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Longitudinal transitions in adolescent polytobacco use across waves 1-4 of the Population Assessment of Tobacco and Health (PATH) study.

AIMS
To identify adolescent patterns of polytobacco use and measure transitions between patterns over time DESIGN: Longitudinal analysis using data derived from Waves 1-4 (2013-2018) of the Population Assessment of Tobacco and Health (PATH) study. Transitions in tobacco use patterns were examined via latent transition analysis, and then sociodemographic characteristics were used to predict transitions via logistic regression SETTING: United States PARTICIPANTS: Participants included 975 adolescents who used at least one tobacco product at any wave (W1 mean age = 13.29, standard deviation = 0.86, 54.2% male; 54.5% White, 25.3% Hispanic) MEASUREMENTS: Measurements included past 30-day use of cigarettes, electronic cigarettes [ECIGs], traditional cigars, cigarillos, filtered cigars, snus, smokeless tobacco [SLT], or hookah FINDINGS: Six latent classes were identified. Cigarette Users (43.5%-58.8%) and SLT Users (50.8%-79.6%) tended to persist in their use over time. ECIG Users started off likely to transition to Nonusers (80.0%) but became more likely to persist in this use over time (31.1%). Nonusers at a given wave were most likely to transition to ECIG Users (8.5%-43.7%) or Cigarette Users (6.7%-28.6%). Cigarillo/Poly Users and Hookah/Poly Users displayed more variable transition patterns. Adolescents were more likely to transition to nonuse (vs become/remain ECIG Users) if they were older (Cigarette Users, SLT Users), younger (ECIG Users), other race (SLT Users), male (SLT Users), or had less educated parents (SLT Users) compared with their counterparts. Hispanic (versus White) Cigarette Users were more likely to transition to Nonusers than to persist in this use.


CONCLUSIONS
Among adolescents in the United States, patterns of tobacco use characterized by the use, mainly, of single, specific products appear to be stable, particularly by late adolescence. In contrast, patterns characterized by polytobacco use appear to be more variable and may represent experimentation without specialization.