Trajectories Of Cigarette Smoking Research Articles

Family Environment and Community Context for Longitudinal Cigarette Smoking Trajectories Among Chinese Young People

Family Environment and Community Context for Longitudinal Cigarette Smoking Trajectories Among Chinese Young People

Characterization of trajectories of physical activity and cigarette smoking from early adolescence to adulthood

BackgroundCigarette smoking and physical inactivity are two critical risk factors for noncommunicable diseases and all-cause mortality. However, few studies have compared the long-term trajectories of both behaviors, as well as multilevel factors associated with trajectory patterns. Using the National Longitudinal Study of Adolescent to Adult Health (Add Health) Wave I through V survey data, this study characterized distinct subgroups of the population sharing similar behavioral patterns from adolescence to adulthood, as well as predictors of subgroup membership for physical activity (PA) and cigarette smoking behavior respectively.MethodsUsing the Add Health Wave I through V survey data, we identified the optimal number of latent classes and class-specific trajectories of PA and cigarette smoking from early adolescence to adulthood, fitting latent growth mixture models with standardized PA score and past 30-day cigarette smoking intensity as outcome measures and age as a continuous time variable. Associations of baseline sociodemographic factors, neighborhood characteristics, and sociopsychological factors with trajectory class membership were assessed using multinomial logistic regression.ResultsWe identified three distinct subgroups of non-linear PA trajectories in the study population: moderately active group (N = 1067, 5%), persistently inactive group (N = 14,257, 69%) and worsening activity group (N = 5410, 26%). Foror cigarette smoking, we identified three distinct non-linear trajectory subgroups: persistent non-smoker (N = 14,939, 72%), gradual quitter (N = 2357, 11%), and progressing smoker (N = 3393, 16%). Sex, race/ethnicity, neighborhood environment and perceived peer support during adolescence were significant predictors of both physical activity and cigarette smoking trajectory subgroup membership from early adolescence to adulthood.ConclusionsThere are three distinct subgroups of individuals sharing similar PA and cigarette smoking behavioral profile respectively from adolescence to adulthood in the Add Health study population. Behavioral interventions that focus on neighborhood environment (e.g. establish community-based activity center) and relationship to peers during adolescence (e.g. peer counseling) could be key to long-term PA promotion and cigarette smoking cessation.

Cigarette smoking trajectories among adolescents and young adults in the Islamic Republic of Iran.

Cigarette smoking follows a progressive pattern throughout the lifetime; most adult smokers started smoking during adolescence. To understand the cigarette smoking trajectories and their predictors among adolescents and young adults in the Islamic Republic of Iran. Using data from the Tehran Lipid and Glucose Study, we followed 1169 adolescents (12-18 years old) into their young adulthood (28-32 years old), from 2002 to 2016. We used cigarette smoking as the outcome variable for group-based trajectory modelling. After detecting the trajectories, we investigated the effects of independent variables, namely, individual employment; education; physical activity; and paternal smoking, employment and education, on the trajectories. We analysed the data using STATA version 16 and SPSS version 26. Three trajectories were detected: non-smokers (79%), experimenters (12%) and escalators (9%). Boys were approximately 3 times (OR = 2.94, 95% CI: 2.32-3.24, P < 0.001) and 25 times (OR = 25.00, 95% CI: 23.92-26.08, P < 0.001), respectively, more likely than girls to be in the experimenter and escalator groups. Receiving a university education decreased the odds of being in the escalator trajectory for 18% (OR = 0.82, 95% CI: -0.04-0.96, P = 0.002) of the study participants. Employment after high school increased the odds by approximately two folds for the experimenter (OR = 2.00, 95% CI: 1.42-2.50, P = 0.01) and escalator (OR = 2.33, 95% CI: 1.33-2.93, P = 0.03) trajectories. Paternal smoking was associated with 1.88 and 2.23, respectively, increased odds of experimenting and escalating smoking among the adolescents. Iranian adolescents follow 3 cigarette smoking trajectories into young adulthood: non-smokers, experimenters and escalators. Male sex, employment after high school, and living with a smoker father were associated with unfavourable smoking patterns. Findings from this study provide valuable insights for designing targeted interventions to reduce cigarette smoking among adults and adolescents in the Islamic Republic of Iran.

Identifying Cigarette Smoking Trajectories from Homelessness to Housing

AbstractThis study examines cigarette smoking trajectories from homelessness to housing and assesses demographic and clinical characteristics associated with multiple longitudinal smoking behavior patterns. Data were drawn from a longitudinal prospective cohort study of 421 adults experiencing homelessness who entered permanent supportive housing (PSH). Four quantitative surveys (baseline [while homeless], 3-, 6-, and 12 months post-housing) gathered participants’ smoking frequency used for Repeated Measure Latent Class Analysis (RMLCA), which identified subgroups that share longitudinal smoking behavior patterns. Baseline and time-varying demographic, mental health (e.g., schizophrenia), and substance use (e.g., cannabis use) measures were examined as correlates of class membership. RMLCA estimates supported a three-class model: (1) mixed-frequency decreasers (n = 71): who smoked at differing frequencies while demonstrating a significant decrease over time; (2) high-frequency maintainers (n = 194): participants who smoked daily/almost-daily and maintained this smoking rate across waves; and (3) low-frequency increasers (n = 56): participants who generally were non-smokers at baseline and significantly increased to monthly or weekly consumption longitudinally. Compared to Black and African American participants, Hispanic and Latino participants had greater odds of low-frequency increaser and mixed-frequency decreaser membership. Schizophrenia and bipolar disorder diagnoses increased odds of high-frequency maintainer membership compared to the two less-frequent-using subgroups. Cannabis use increased longitudinally and was associated with greater odds of high-frequency maintainer membership. This is the first study to find smoking changes from homelessness to housing. While encouraging that some residents reduce their smoking post-housing, many maintained high smoking rates. Cessation services that address mental health and co-occurring substance use within PSH are warranted.

Cumulative cigarette discount coupon exposure and trajectories of cigarette smoking: a longitudinal analysis in US adults

IntroductionExposure to cigarette discount coupons is associated with short-term increase in cigarette smoking; however, long-term impact is unclear. This study examined associations of cumulative exposure to cigarette coupons with trajectories...

Examining Differences in Alcohol and Smoking Behaviors between Parenting and Nonparenting Lesbian Women

Background The transition to parenthood is a significant life event that has implications for health behaviors and health. Few studies have examined alcohol use and smoking by parenthood status (nonparent vs. parent) among women who identify as lesbian. Methods This study used data from two longitudinal studies, the Chicago Health and Life Experiences of Women Study (n = 135) and the U.S. National Longitudinal Lesbian Family Study (n = 116), to compare problem drinking and cigarette smoking trajectories among lesbian-identified women by parenthood status. We used mixed models to investigate differences in problem drinking and cigarette smoking in three waves of data in each study. Results Lesbian parents reported significantly less problem drinking, but not cigarette smoking, than nonparent lesbian women. When considering the interaction between parental status and time, problem drinking was significantly higher among nonparents than parents at each time interval. Conclusions Parenthood was associated with positive changes in drinking among lesbian women; however, more research is needed to understand how to support smoking cessation among parenting lesbian women.

Predictors of E-cigarette and Cigarette Use Trajectory Classes from Early Adolescence to Emerging Adulthood Across Four Years (2013-2017) of the PATH Study.

This study examines predictors of trajectories of cigarette and e-cigarette use among a cohort of US adolescents transitioning into young adulthood. Comparing trajectories of each tobacco product is important to determine if different intervention targets are needed to prevent progression to daily use. Latent trajectory class analyses identified cigarette and e-cigarette use (never, ever excluding past 12-month, past 12-month (excluding past 30-day (P30D)), P30D 1-5 days, P30D 6+ days) trajectory classes, separately, among US youth (12-17; N = 10,086) using the first 4 waves (2013-2017) of data from the nationally representative PATH Study. Weighted descriptive analyses described the class characteristics. Weighted multinomial logistic regression analyses examined demographic, psychosocial, and behavioral predictors of class membership. Younger adolescents 12-15 years had lower tobacco use compared to 16-17 year olds and less stable classes. In the 16-17 year group, there were five unique trajectories of cigarette smoking, including a Persistent High Frequency class. Four e-cigarette use trajectories were identified; but not a persistent use class. Shared predictors of class membership for cigarettes and e-cigarettes included mental health problems, other tobacco use, marijuana use, and poorer academic achievement. Male sex and household tobacco use were unique e-cigarette trajectory class predictors. There was no evidence that initiation with e-cigarettes as the first product tried was associated with cigarette progression (nor cigarettes as first product and e-cigarette progression). Interventions should focus on well-established risk factors such as mental health and other substance use to prevent progression of use for both tobacco products. Using nationally representative data and definitions of use that take into account frequency and recency of use, longitudinal 4-year trajectories of e-cigarette and cigarette use among US adolescents transitioning into young adulthood were identified. Results among 16-17-year olds revealed a class of persistent high frequency cigarette smoking that was not identified for e-cigarette use. Cigarette use progression was not associated with e-cigarettes as the first product tried. Risk factors for progression of use of both products included mental health and other substance use, which are important prevention targets for both tobacco products.

Cigarette Smoking Trajectories in Adolescent Smokers: Does the Time Axis Metric Matter?

Most studies modeling adolescent cigarette smoking trajectories use age as the time axis, possibly obscuring depiction of the natural course of cigarette smoking. We used a simulated example and real data to contrast smoking trajectories obtained from models that used time since smoking onset or calendar time (age) as the time axis. Data were drawn from a longitudinal investigation of 1293 grade 7 students (mean age 12.8 years) recruited from 10 high schools in Montreal, Canada in 1999-2000, who were followed into young adulthood. Cigarette consumption was measured every 3 months during high school, and again at mean ages 20.4 and 24.0. Analyses using time since onset of smoking as the time metric was restricted to 307 incident smokers; analysis using calendar time included 645 prevalent and incident smokers. Smoking status and nicotine dependence (ND) were assessed at mean ages 20.4 and 24.0. Simulated data mimicked the real study during high school. Use of different time metrics resulted in different numbers and shapes of trajectories in the simulated and real datasets. Participants in the calendar time analyses reported more ND in young adulthood, reflecting inclusion of 388 prevalent smokers who had smoked for longer durations. Choosing the right time metric for trajectory analysis should be balanced against research intent. Trajectory analyses using the time since onset metric depict the natural course of smoking in incident smokers. Those using calendar time offer a snapshot of smoking across ages during a given time period. This study uses simulated and real data to show that trajectory analyses of cigarette smoking that use calendar time (e.g., age) versus time since onset as the time axis metric tell a different story. Trajectory analyses using the time since onset metric depict the natural course of smoking in incident smokers. Those using calendar time offer a snapshot of smoking across ages during a given time period. Choosing the right time metric should be balanced against research intent.

The Type and Timing of Child Maltreatment as Predictors of Adolescent Cigarette Smoking Trajectories

Background: There is limited research examining the association between child maltreatment and cigarette smoking as a specific type of adolescent substance use, and research examining high-risk samples and variations based on maltreatment type and timing remain sparse. Objectives: The primary aim of the study was to examine the relationship between child maltreatment and cigarette smoking trajectories. Methods: Latent class growth analysis and multinomial logistic regression were performed on 903 youth drawn from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). Results: Three distinct classes of cigarette smoking trajectories were identified: (1) Stable no/low cigarette use (61%); (2) Gradually increasing cigarette use (30%); and (3) Sharply increasing cigarette use (9%). Physical abuse during early childhood and adolescence predicted membership in the sharply increasing cigarette use class. Neglect during early childhood predicted membership in the gradually increasing cigarette use class. Conclusions: Findings suggest that interventions for adolescent cigarette smoking should integrate trauma-informed approaches. Further, the results highlight early childhood and adolescence as particularly vulnerable periods with respect to the influence of physical abuse and neglect on cigarette smoking, pointing to the need for additional maltreatment prevention efforts during these developmental stages.

Cigarette Smoking and Nicotine Dependence Trajectories Among Incident Adolescent Smokers.

Few interventions target adolescent cigarette smokers to prevent escalation in cigarette use or promote cessation, in part because little is known about co-developing smoking and nicotine dependence (ND). Our objectives were to: (1) estimate developmental trajectories of ND/cravings, withdrawal symptoms, the modified Fagerström Tolerance Questionnaire (mFTQ) and ICD-10 tobacco dependence in incident adolescent smokers; (2) describe concordance in number and shapes of trajectories across the four ND indicators; and (3) classify participants in each ND trajectory according to cigarette smoking trajectories. Data were drawn from an ongoing longitudinal investigation of 1294 grade 7 students recruited in 1999-2000 in 10 Montreal-area high schools. Group-based joint trajectory models were used to identify distinct subgroups defined by the four ND indicators, in 307 incident smokers. The optimal trajectory model included five groups for ND/craving and four groups for each of withdrawal symptoms, the mFTQ and ICD-10 tobacco dependence. The four ND indicators showed similar developmental patterns and classification into smoking trajectory groups, although some discordance was observed. Smokers in the low-level decreaser group and stable low consumers who exhibited high ND were younger than those in the cigarette-low ND trajectory groups. Moderate or rapid escalators who exhibited no/low ND were less likely to have university-educated mothers and more likely to have parents who smoke. Trajectories were similar across ND indicators, and generally reflected cigarette smoking trajectory shapes. Novice smokers may need education to become self-aware of developing ND symptoms, as well as to learn about alternative courses of action once ND symptoms manifest. Trajectories of cigarette smoking and ND symptoms have rarely been investigated concurrently. This study provides evidence of high concordance across four distinct ND indicators in the proportion of participants with no/low-level dependence, and with high or increasing ND. Moreover, the development of cigarette smoking is concordant with ND symptom development. Interventions to prevent escalation and promote cessation should target adolescents before first puff to increase self-awareness of developing ND symptoms, as well as to learn about alternative courses of action once ND symptoms are experienced.

Parents, Peers, and Trajectories of Cigarette Smoking: A Group-Based Approach.

This study examines the independent, relative, and additive associations between both parent and peer role models and longitudinal patterns of smoking across adolescence and early adulthood. An analysis of data from the National Longitudinal Study of Adolescent to Adult Health (N=10,166) reveals at least four distinct trajectories of smoking across ages 13-35: (1) non-smokers; (2) late peak (almost 10 cigarettes per day around age 30); (3) an early peak group that reached roughly 10 cigarettes per day around age 20 and declined; and (4) a high group that increased during adolescence and early adulthood and then remained high. Parent and peer smoking behaviors were associated with trajectory group membership net of controls for sociodemographic characteristics, parental SES, parent-child relations, and the availability of cigarettes in the family home. Parents and peers appear to have at least some independent associations net of each other, but their combined effects are powerful.

Adolescent tolerance for deviance, cigarette smoking trajectories, and premature mortality: A longitudinal study

Cigarette smoking is a well-established cause of excess morbidity and mortality in the United States and globally. The current study builds on the existing literature by examining how smoking trajectories might be a mechanism through which adolescent tolerance for deviance predicts premature all-cause and tobacco-specific mortality. Participants were from a cohort-sequential study conducted in the Midwestern United States of the natural history of cigarette smoking from adolescence through midlife that collected nine waves of data from 1980 to 2011. For the current study, we selected participants who were measured at least once at age 18 or older and who did not die before age 24 (n = 7575). Participants' tolerance for deviance was assessed in adolescence, smoking trajectory group was based on self-reported smoking status during the first six waves of data collection, and cause of death for deceased participants (n = 222) was obtained from the National Death Index. Mediation analyses using the joint significance test were conducted separately for all-cause mortality and tobacco-specific mortality. Adolescent tolerance for deviance significantly predicted smoking trajectory group over and above the influence of covariates. Adolescents with higher tolerance for deviance were more likely to belong to any smoking trajectory group compared to abstainers, and membership in a smoking trajectory group characterized by early onset and heavy, persistent smoking was related to premature all-cause and tobacco-specific mortality. Finally, smoking trajectory group was a significant mediator of the relation between adolescent tolerance for deviance and all-cause mortality.

Abstract 5246: Lifetime trajectories of cigarette smoking and cancer mortality among older adults in a large cohort in the United States

Abstract Background: Despite declining prevalence, cigarette smoking causes about 30% of all cancer deaths in the United States. More than a quarter of daily cigarette smokers in the United States smoke 10 or less cigarettes per day (CPD), encompassing a heterogeneous group of lifelong low-intensity smokers and formerly heavier smokers who have cut down their CPD. The impact of prior smoking history on the disease risks of low-intensity cigarette smokers is poorly understood. Methods: In the National Institutes of Health-AARP Diet and Health Study, a prospective cohort study of older adults in the United States, a questionnaire administered in 2004-2005 assessed CPD during nine age-periods over the lifetime (&amp;lt;15 to ≥70). This analysis included 121,025 men and women aged 60-82 who reported never smoking cigarettes (n=110,444) or currently smoking &amp;lt;1 or 1-10 CPD (low intensity smokers, n=10,581). We used fixed-effects latent class trajectory modeling to define lifetime trajectories of prior CPD smoking history among low-intensity cigarette smokers. Then, we calculated sex-specific multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for each trajectory relative to never smokers using Cox proportional hazards regression for overall and lung cancer mortality. Results: We identified nine trajectory patterns in both men and women. Mortality risks varied substantially by trajectory: the HRs for overall cancer mortality ranged from 1.17 to 4.03 in men and 0.83 to 3.42 in women. Similarly, the HRs for lung cancer mortality ranged from 5.20 to 23.88 in men and 8.00 to 23.08 in women. Mortality risks were substantially higher among participants who had cut down their CPD than among participants who reported smoking at low-intensity for all age-periods that they smoked. For example, in men, the HR for lung cancer mortality was 23.88 (95% CI=12.10-47.13) among low-intensity smokers who previously smoked 31-40 CPD, whereas it was 9.36 (95% CI=5.92-14.79) among lifelong 1-10 CPD smokers. Similarly, in women, the HR for lung cancer mortality was 19.76 (95% CI=8.71-44.85) among women who previously smoked 21-30 CPD, whereas it was 9.26 (95% CI=2.98-14.34) among lifelong 1-10 CPD smokers. Conclusions: In a large prospective cohort study of older adults in the United States, risks among low-intensity smokers for overall and lung-cancer mortality varied substantially by prior smoking history. These results suggest that it is important for risk prediction models, such as for lung cancer-screening, to incorporate lifetime smoking history into their algorithms. Citation Format: Maki Inoue-Choi, Scott P. Kelly, Kelvin Choi, Neal D. Freedman. Lifetime trajectories of cigarette smoking and cancer mortality among older adults in a large cohort in the United States [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5246.

Cigarette use trajectories in young adults: Analyses of predictors across system levels

BackgroundCigarette smoking escalates most in early to middle young adulthood. However, little research has examined a range of multilevel factors in relation to smoking trajectories during this time. MethodsWe examined: 1) trajectories of cigarette smoking among 2967 US college students (aged 18–25) in a two-year, six-wave longitudinal study (using growth mixture modeling); and 2) intrapersonal- (i.e., other substance use, depressive symptoms, ADHD symptoms,); interpersonal- (i.e., adverse childhood events, social support, parental tobacco and marijuana use), and community-level (i.e., type of college, rural vs. urban setting) predictors of differing trajectories (using multinomial logistic regression). ResultsWe identified three trajectory classes: 1) Dabblers, who used cigarettes at one point in their life or not at all (85.6%); 2) College Onset Smokers, who began smoking regularly during the college years (6.2%); and 3) Later Onset Smokers, who began smoking during the mid- to late-20 s (8.2%). Multinomial regression (with Dabblers as the reference group) showed that predictors of being College Onset Smokers included being male (p = .031); Asian (p = .001) but not Black (p = .008; Ref: White); early onset smokers (i.e., initiation before age 15; p = .006); past 30-day users of little cigars/cigarillos (p = .024), alcohol (p < .001), and marijuana (p = .008); children of tobacco users (p = .050); and public (p = .031) or a technical college students (p < .001; Ref: private college); predictors of being Later Onset Smokers were being male (p = .019) and technical college students (p = .005). ConclusionsDespite some young adults’ smoking initiating/escalating in middle young adulthood, few risk factors were documented. This understudied period warrants greater examination to inform intervention.

Smoking Trajectory Classes and Impact of Social Smoking Identity in Two Cohorts of U.S. Young Adults.

This study describes cigarette smoking trajectories, the influence of social smoker self-identification (SSID), and correlates of these trajectories in two cohorts of U.S. young adults: a sample from the Chicago metropolitan area (Social Emotional Contexts of Adolescent and Young Adult Smoking Patterns [SECAP], n = 893) and a national sample (Truth Initiative Young Adult Cohort Study [YA Cohort], n = 1,491). Using latent class growth analyses and growth mixture models, five smoking trajectories were identified in each sample: in SECAP: nonsmoking (n = 658, 73.7%), declining smoking (n = 20, 2.2%), moderate/stable smoking (n = 114, 12.8%), high/stable smoking (n = 79, 8.9%), and escalating smoking (n = 22, 2.5%); and in YA Cohort: nonsmoking (n = 1,215, 81.5%), slowly declining smoking (n = 52, 3.5%), rapidly declining smoking (n = 50, 3.4%), stable smoking (n = 139, 9%), and escalating smoking (n = 35, 2.4%). SSID was most prevalent in moderate/stable smoking (35.5% SECAP), rapidly declining smoking (25.2% YA Cohort), and nonsmoking. Understanding nuances of how smoking identity is formed and used to limit or facilitate smoking behavior in young adults will allow for more effective interventions to reduce tobacco use.

Dual Trajectories of Sleep Duration and Cigarette Smoking during Adolescence: Relation to Subsequent Internalizing Problems.

Decreasing sleep duration and increasing cigarette smoking of adolescents are major public health concerns. However, research examining connections between the developmental trajectories of the outcomes that are evolving contemporaneously and their relation to long-term outcomes is still lacking. This study examined distinct trajectories of sleep duration and cigarette smoking during adolescence, associations between these trajectories, and links with internalizing problems during young adulthood. Data were collected from 2510 adolescents who participated in a longitudinal study spanning from 2006 through 2014 in northern Taiwan. Group-based dual trajectory modeling was used to examine the dynamic relationships between sleep duration and cigarette smoking trajectories during adolescence. Multiple linear regression was used to understand the association between the distinct trajectories and subsequent internalizing problems. Three sleep duration trajectories (short decreasing, typical sleep, and long sleep) and three cigarette smoking trajectories (nonsmokers, late increasing, and escalating smokers) were identified. We found significant inter-relationships for sleep duration and cigarette smoking trajectories during adolescence; all atypical sleep duration trajectories conferred increased risks of increased cigarette smoking and vice versa. In addition, the effects of sleep duration and cigarette smoking on later internalizing problems were found to vary by sex and trajectory patterns. These results provide insight regarding the co-development of sleep duration and cigarette smoking trajectories during adolescence. We also highlight the different roles of sleep duration and cigarette smoking trajectories and their relation to internalizing problems of young adulthood.

Understanding the Relationship of Cigarette Smoking Trajectories Through Adolescence and Weight Status in Young Adulthood in the United States

PurposeAdolescent cigarette smoking has steadily declined since 1999, whereas adolescent obesity rates have quadrupled since the 1980s. Few studies address the longitudinal relationship of smoking and weight in youth and young adulthood. This study examines the relationship of smoking trajectories beginning in adolescence on weight status in young adulthood in a nationally representative longitudinal sample. MethodsThe study sample was drawn from the National Longitudinal Study of Adolescent to Adult Health Waves I–IV (N = 13,361). Four trajectories were generated through repeated-measures latent class analyses using current cigarette smoking status in Waves I–IV and age of initiation: nonsmokers (44%), early establishers (23%), late establishers (21%), and former smokers (12%). Wave IV weight status included self-reported body mass index (BMI) and measured waist circumference. Bivariate analyses addressed associations between smoking trajectory and BMI at each wave. Multivariate linear regression models tested the relationship of smoking trajectory and weight status at Wave IV. ResultsIn bivariate analyses, early and late establishers had a significantly lower BMI at Wave III and all smoking trajectories had a significantly lower BMI at Wave IV versus nonsmokers. All smoking trajectories had a significantly lower BMI than nonsmokers (early establishers: β = −1.27, confidence interval [CI]: −1.56 to −.98]; late establishers: β = −.84, CI: −1.16 to −.52; and former smokers: β = −.63, CI: −.93 to −.34; p < .05) in an adjusted multivariable regression model. ConclusionsThis study reveals that weight status increased over time for all trajectories; thus smoking does not mitigate obesity risk. These results have implications for both research and interventions to help youth and young adults avoid both smoking and obesity.

Lack of Preventive Health Behaviors in the Early Forties: The Role of Earlier Trajectories of Cigarette Smoking From Adolescence to Adulthood

ABSTRACTObjective: To study the degree to which individuals in different trajectories of cigarette smoking from adolescence to the early forties are similar or different in terms of lack of preventive health behaviors (e.g., underuse of preventive health services, unhealthy eating habits) in early midlife. Methods: Participants came from a community-based random sample of residents in two upstate New York counties (N = 548). Data were collected from adolescence to early midlife (mean age = 43 years, standard deviation [SD] = 2.8) at seven time points. Using growth mixture modeling, we statistically identified the number of smoking trajectories. Logistic regression analysis was used to study the relationship between the probabilities of participants' smoking trajectory group membership and lack of preventive behaviors in early midlife. Results: Five trajectory groups of cigarette smokers were identified. With controls, as compared with the nonsmoker trajectory group, higher probabilities of belonging to the heavy/continuous smoker trajectory group and the late starter trajectory groups were significantly associated with a higher likelihood of lack of preventive health behaviors (adjusted odds ratio [AOR] = 3.49 and 4.02 respectively). In addition, as compared to the quitter/decreaser trajectory group, higher probabilities of belonging to the heavy/continuous smoker trajectory group and the late starter trajectory group were also significantly associated with a higher likelihood of lack of preventive health behaviors (AOR = 3.51 and 4.04 respectively). Conclusions: Intervention programs may consider focusing on heavy/continuous smokers and late starters in programs designed to promote adequate use of preventive health services and healthy general lifestyles in early midlife.

Joint trajectories of cigarette smoking and depressive symptoms from the mid-20s to the mid-30s predicting generalized anxiety disorder

ABSTRACTThe current study examines longitudinal patterns of cigarette smoking and depressive symptoms as predictors of generalized anxiety disorder using data from the Harlem Longitudinal Development Study. There were 674 African American (53%) and Puerto Rican (47%) participants. Among the 674 participants, 60% were females. In the logistic regression analyses, the indicators of membership in each of the joint trajectories of cigarette smoking and depressive symptoms from the mid-20s to the mid-30s were used as the independent variables, and the diagnosis of generalized anxiety disorder in the mid-30s was used as the dependent variable. The high cigarette smoking with high depressive symptoms group and the low cigarette smoking with high depressive symptoms group were associated with an increased likelihood of having generalized anxiety disorder as compared to the no cigarette smoking with low depressive symptoms group. The findings shed light on the prevention and treatment of generalized anxiety disorder.

Trajectories of Cigarette Smoking From Teens to Young Adulthood: 2000 to 2013.

To identify trajectories of smoking behaviors of a cohort of youth followed through young adulthood from 2000 to 2013. The Minnesota Adolescent Community Cohort study, a population-based cohort study. Nationwide, originating in the Midwestern United States. Cohort of youth surveyed for 14 years beginning at ages 12 to 16 (N = 4241 at baseline; 59% recruitment rate). Main variable of interest was the number of days smoked in the past 30 days. Also included time-varying and time-invariant covariates. We utilized growth mixture modeling to group individuals into trajectories over time. We identified 5 distinct trajectories: nonsmokers (59.5%), early-onset regular smokers (14.2%), occasional smokers (11.5%), late-onset regular smokers (9.4%), and quitters (5.3%). Adjusted models showed that early- and late-onset regular smokers (compared to nonsmokers) had lower odds of attending or graduating from a 4-year college ( P < .05). Participants in all smoking classes compared to nonsmokers had greater odds of having more close friends who smoked ( P < .05). Our results show that individuals in their teens through young adulthood can be classified into 5 smoking trajectories. More people in this age range remained abstainers than found in most previous studies; however, a sizable group was identified as regular smokers by the time they reached young adulthood. Interventions targeted at teens, including those that address social and environmental influences, are clearly still needed to prevent escalation of smoking as they move toward young adulthood.