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Defining Subgroups of Adolescents at Risk for Experimental and Regular Smoking

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Abstract

If multiple etiologies of substance use are truly at work in the population, then further strides in the accurate prediction of smoking and the use of other substances will likely be built on diverse pattern-centered approaches that explore the presence of multiple population subgroups across various substance use stages. The present study aimed to identify population subgroups defined by individual risk factors or risk factor constellations that prospectively predict specific smoking stages. Using data from the National Longitudinal Study of Adolescent Health (Add Health), analyses were conducted on the sample that took part in the baseline and 1 year follow-up assessment between 1994 and 1996. Classification and regression tree procedures were used to investigate the structure of individual risk factors, or constellations of risk, that define population subgroups with high rates of both experimental and established smoking. For each level of smoking, a relatively simple model including two subgroups predicted over half of the smoking cases. Findings also indicated that the two group models identified higher rates of regular smokers compared to experimental smokers. Deviant behaviors and alcohol use without permission independently predicted movement to experimentation at follow-up. Progression to regular smoking from both a nonsmoking and experimental smoking status at baseline were each predicted by smoking friends. Additionally, baseline levels of experimental use predicted movement from experimental to regular smoking, while a relatively low grade point average predicted rapid progression from baseline nonuse to regular use at follow-up. By identifying first approximations of patterns, these analyses may lead to clues regarding the major multiple mechanisms at work for the progression of smoking among adolescents.

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REFERENCES

  • Adalbjarnardottir, S., & Rafnsson, F. D. (2002). Adolescent antisocial behavior and substance use: Longitudinal analyses. Addictive Behaviors, 27(2), 227-240.

    Article  PubMed  Google Scholar 

  • Alexander, C. S., Allen, P., Crawford, M. A., & McCormick, L. K. (1999). Taking a first puff: Cigarette smoking experiences among ethnically diverse adolescents. Ethnicity and Health, 4(4), 245-257.

    Article  PubMed  Google Scholar 

  • Allen, O., Page, R.M., Moore, L., & Hewitt, C. (1994). Gender differences in selected psychosocial characteristics of adolescent smokers and nonsmokers. Health Values, 18(2), 34-39.

    Google Scholar 

  • Ary,D.V., & Biglan, A. (1988). Longitudinal changes in adolescent cigarette smoking behavior: onset and cessation. Journal of Behavioral Medicine, 11(4), 361-382.

    PubMed  Google Scholar 

  • Bates, M. E. (2000). Integrating person-centered and variablecentered approaches in the study of developmental courses and transitions in alcohol use: Introduction to the special section. Alcoholism: Clinical and Experimental Research, 24(6), 878-881.

    Article  Google Scholar 

  • Botvin, G. J., Baker, E., Goldberg, C. J., Dusenbury, L., Botvin, E. (1992). Correlates and predictors of smoking among Black adolescents. Addictive Behaviors, 17(2), 97-103.

    PubMed  Google Scholar 

  • Boyle,M. H., Offord, D. R., Racine, Y. A., Fleming, J. E., & Links, P. S. (1993). Predicting substance abuse in early adolescence based on parent and teacher assessments of childhood psychiatric disorder: Results from the Ontario Child Health Study follow-up. Journal of Child Psychology and Psychiatry and Allied Disciplines, 34(4), 535-544.

    Google Scholar 

  • Breiman, L., Friedman, J. H., Ohlsen, R. A., & Stone, C. J. (1984). Classification and regression trees.Belmont: Wadsworth International Group.

    Google Scholar 

  • Brown, R. A., Lewinsohn, P. M., Seeley, J. R., & Wagner, E. F. (1996). Cigarette smoking, major depression, and other psychiatric disorders among adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 35(12), 1602- 1610.

    PubMed  Google Scholar 

  • Bryant, A. L., Schulenberg, J., Bachman, J. G., O'Malley, P. M., & Johnston, L. D. (2001). Understanding the links among school misbehavior, academic achievement, and cigarette use: A national panel study of adolescents. Prevention Science, 1(2), 71- 87.

    Article  Google Scholar 

  • CDC (2002). Annual smoking-Attributable mortality, years of potential life lost, and economic costs-United States, 1995-1999 (Morbidity and Mortality Weekly Report). Washington, DC: U.S. Department of Health and Human Services.

    Google Scholar 

  • Chassin, L., Presson, C. C., Pitts, S. C., & Sherman, S. J. (2000). The natural history of cigarette smoking from adolescence to adulthood in a midwestern community sample: Multiple trajectories and their psychosocial correlates. Health Psychology, 19(3), 223-231.

    PubMed  Google Scholar 

  • Chassin, L., Presson, C. C., Sherman, S. J., & Edwards,D.A. (1991). Four pathways to young-adult smoking status: Adolescent social-psychological antecedents in a midwestern community sample. Health Psychology, 10(6), 409-418.

    PubMed  Google Scholar 

  • Chassin, L., Presson, C. C., Sherman, S. J., & Edwards,D.A. (1992). Parent educational attainment and adolescent cigarette smoking. Journal of Substance Abuse, 4(3), 219-234.

    PubMed  Google Scholar 

  • Choi, W. S., Pierce, J. P., Gilpin, E. A., Farkas, A. J., & Berry, C. C. (1997).Which adolescent experimenters progress to established smoking in the United States. American Journal of Preventive Medicine, 13(5), 385-391.

    PubMed  Google Scholar 

  • Cloninger, C., Bohman, M., & Sigvardsson, S. (1981). Inheritance of alcohol abuse: cross-fostering analysis of adopted men. Archives of General Psychiatry, 38 ,861-868.

    PubMed  Google Scholar 

  • Cloninger,C., Sigvardsson, S., Gilligan, S., von Knorring, A., Reich, T., & Bohman, M. (1988). Genetic heterogeneity and the classification of alcoholism. Advances in Alcohol and Substance Abuse, 7 ,3-16.

    Google Scholar 

  • Conrad, K. M., Flay, B. R., & Hill, D. (1992). Why children start smoking cigarettes: Predictors of onset. British Journal of Addiction, 87(12), 1711-1724.

    PubMed  Google Scholar 

  • Curran, G. M., Stoltenberg, S. F., Hill, E. M., Mudd, S. A., Blow, F. C., & Zucker, R. A. (1999). Gender differences in the relationship among SES, family history of alcohol disorders and alcohol dependence. Journal of Studies on Alcohol, 60(6), 825- 832.

    PubMed  Google Scholar 

  • Dielman, T. E., Campanelli, P. C., Shope, J. T., & Butchart, A. T. (1988). Susceptibility to peer pressure, self-esteem, and health locus of control as correlates of adolescent substance abuse. Health Education Quarterly, 14(2), 207-221.

    Google Scholar 

  • Duncan, S. C., Duncan, T. E., & Hops, H. (1998). Progressions of alcohol, cigarette, and marijuana use in adolescence. Journal of Behavioral Medicine, 21(4), 375-388.

    Article  PubMed  Google Scholar 

  • Elders,M., & Perry,C. (1994). Preventing tobacco use among young people: a report of the Surgeon General. MMWR, 43, 2-10.

    Google Scholar 

  • Epstein, J. A., Botvin, G. J., Baker, E., & Diaz, T. (1999). Impact of social influences and problem behavior on alcohol use among inner-city Hispanic and black adolescents. Journal of Studies on Alcohol, 60(5), 595-604.

    PubMed  Google Scholar 

  • Feigelman, W., & Lee, J. (1995). Probing the paradoxical pattern of cigarette smoking among African-Americans: Low teenage consumption and high adult use. Journal of Drug Education, 25(4), 307-320.

    PubMed  Google Scholar 

  • Flay, B. R., Hu, F. B., Siddiqui, O., Day, L. E., et al.(1994). Differential influence of parental smoking and friends' smoking on adolescent initiation and escalation of smoking. Journal of Health and Social Behavior, 35(3), 248-265.

    PubMed  Google Scholar 

  • Flint, A. J., Yamada, E. G., & Novotny, T. E. (1998). Black-white differences in cigarette smoking uptake: Progression from adolescent experimentation to regular use. Preventive Medicine: An International Devoted to Practice and Theory, 27(3), 358- 364.

    Google Scholar 

  • Forster, J. L., Wolfson, M., Muray, D. M., Wagenaar, A. C., & Claxton, A. J. (1997). Perceived and measured availability of tobacco to youths in 14 Minnesota communities: The TPOP study. American Journal of Preventive Medicine, 13(3), 167- 174.

    PubMed  Google Scholar 

  • Glantz, M. D. (1992). A developmental psychopathology model of drug abuse vulnerability. In Glantz, M., Pickens, R.W. (Eds.), Vulnerability to drug abuse(pp. 389-418). Washington, DC: American Psychological Association.

    Google Scholar 

  • Glantz, M.D., & Pickens, R.W. (Eds.) (1992). Vulnerability to drug abuse. Washington, DC: American Psychological Association Press.

    Google Scholar 

  • Griesler, P. C., & Kandel, D. B. (1998). Ethnic differences in correlates of adolescent cigarette smoking. Journal of Adolescent Health, 23(3), 167-180.

    Article  PubMed  Google Scholar 

  • Gritz, E. R., Prokhorov,A.V., Hudmon, K. S., Chamberlain, R. M., Taylor,W.C., DiClemente,C.C., Johnston, D. A., Hu, S., Jones, L. A., Jones, M. M., Rosenblum, C. K., Ayars, C. L., & Amos, C. I. (1998). Cigarette smoking in a multiethnic population of youth: Methods and baseline findings. Preventive Medicine:An International Devoted to Practice and Theory, 27(3), 365-384.

    Google Scholar 

  • Group, Conduct Problems Prevention Research (2000). Merging universal and indicated prevention programs: The Fast Track model. Addictive Behaviors, 25 ,913-927.

    Article  PubMed  Google Scholar 

  • Harrell, J. S., Bangdiwala, S. I., Deng, S., Webb, J. P., & Bradley, C. (1998). Smoking initiation in youth: The roles of gender, race, socioeconomics, and developmental status. Journal of Adolescent Health, 23(5), 271-279.

    Article  PubMed  Google Scholar 

  • Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992, July). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112(1), 64-105.

    Google Scholar 

  • Headen, S.W., Bauman, K. E., Deane, G. D., & Koch, G. G. (1991). Are the correlates of cigarette smoking initiation different for Black andWhite adolescents? American Journal of Public Health, 81(7), 854-858.

    PubMed  Google Scholar 

  • IOM (1996).Aplan for prevention research for the NIMH (NIH 96-4093).Washington, DC: National Institute of Mental Health.

    Google Scholar 

  • Jackson, C. (1997). Initial and experimental stages of tobacco and alcohol use during late childhood: Relation to peer, parent, and personal risk factors. Addictive Behaviors, 22(5), 685-698.

    Article  PubMed  Google Scholar 

  • Jackson, K. M., Sher, K. J., Cooper, M. L., & Wood, P. K. (2002). Adolescent alcohol and tobacco use: Onset, persistence and trajectories of use across two samples. Addiction, 97(5), 517- 531.

    Article  PubMed  Google Scholar 

  • Jessor, R., & Jessor, L. (1977). Problem behavior and psychosocial development-A longitudinal study of youth. New York: Academic Press.

    Google Scholar 

  • Juon, H.-S., Ensminger, M. E., & Sydnor, K. D. (2002). A longitudinal study of developmental trajectories to young adult cigarette smoking. Drug and Alcohol Dependence, 66(3), 303- 314.

    Article  PubMed  Google Scholar 

  • Kandel, D. B. (1982). Epidemiological and psychosocial perspectives on adolescent drug use. Journal of the American Academy of Child Psychiatry, 21(4), 328-347.

    PubMed  Google Scholar 

  • Kandel, D. B., Wu, P., & Davies,M. (1994). Maternal smoking during pregnancy and smoking by adolescent daughters. American Journal of Public Health, 84(9), 1407-1413.

    PubMed  Google Scholar 

  • Kraemer, H. C. (1992). Evaluating medical tests. Newbury Park, CA: Sage.

    Google Scholar 

  • Kumpfer, K. L., Molgaard, V., & Spoth, R. (1996). The Strengthening Families Program for the prevention of delinquency and drug use. In R. J. McMahon (Ed.), Preventing childhood disorders, substance abuse, and delinquency (pp. 241-267). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Landrine, H., Richardson, J. L., Klonoff, E. A., & Flay, B.R. (1994). Cultural diversity in the predictors of adolescent cigarette smoking: The relative influence of peers. Journal of Behavioral Medicine, 17(3), 331-346.

    PubMed  Google Scholar 

  • Mackesy-Amiti, M. E., Fendrich, M., & Goldstein, P. J. (1997). Sequence of drug use among serious drug users: Typical vs. atypical progression.Drug and Alcohol Dependence, 45(3), 185- 196.

    Article  PubMed  Google Scholar 

  • Maddahian, E., Newcomb, M. D., & Bentler, P. M. (1987). Adolescents' substance use: Impact of ethnicity, income, and availability. Advances in Alcohol and Substance Abuse, 5(3), 63-78.

    Google Scholar 

  • Maddahian, E., Newcomb,M.D., & Bentler, P.M. (1988). Risk factors for substance use: Ethnic differences among adolescents. Journal of Substance Abuse, 1(1), 11-23.

    PubMed  Google Scholar 

  • Mayhew, K., Flay, B. R., & Mott, J. A. (2000). Stages in the development of adolescent smoking. Drug and Alcohol Dependence, 59(Suppl. 1), S61-S81.

    Article  PubMed  Google Scholar 

  • McMahon, R. J., & Slough,N. M. (1996). Family-based intervention in the Fast Track Program. In R. J. McMahon (Ed.), Preventing childhood disorders, substance abuse, and delinquency (pp. 90- 110). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Miller-Johnson, S., Lochman, J. E., Coie, J. D., Terry, R., & Hyman, C. (1998). Comorbidity of conduct and depressive problems at sixth grade: Substance use outcomes across adolescence. Journal of Abnormal Child Psychology, 26(3), 221-232.

    Article  PubMed  Google Scholar 

  • Mittelmark, M. B., Murray, D. M., Luepker, R. V., Pechacek, T. F., Pirie, P. L., & Pallonen, U. E. (1987). Predicting experimentation with cigarettes: The childhood antecedents of smoking study (CASS). American Journal of Public Health, 77(2), 206- 208.

    PubMed  Google Scholar 

  • Mrazek, P. J., & Haggerty, R. J. (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington, DC: National Academy Press.

    Google Scholar 

  • Oetting, E. R., & Beauvais, F. (1986). Peer cluster theory: Drugs and the adolescent. Journal of Counseling and Development, 65(1), 17-22.

    Google Scholar 

  • Oetting, E. R., & Beauvais, F. (1987). Peer cluster theory, socialization characteristics, and adolescent drug use: A path analysis. Journal of Counseling Psychology, 34(2), 205-213.

    Article  Google Scholar 

  • Patton, G. C., Carlin, J. B., Coffey, C., Wolfe, R., Hibbert, M., & Bowes,G. (1998). Depression, anxiety, and smoking initiation: A prospective study over 3 years. American Journal of Public Health, 88(10), 1518-1522.

    PubMed  Google Scholar 

  • Pederson, L. L., Koval, J. J., McGrady, G. A., & Tyas, S. L. (1998). The degree and type of relationship between psychosocial variables and smoking status for students in Grade 8: Is there a dose-response relationship? Preventive Medicine: An International Devoted to Practice and Theory, 27(3), 337-347.

    Google Scholar 

  • Pierce, J. P., Choi, W. S., Gilpin, E. A., Farkas, A. J., & Merritt, R. K. (1996). Validation of susceptibility as a predictor of which adolescents take up smoking in the United States. Health Psychology, 15(5), 355-361.

    Article  PubMed  Google Scholar 

  • Pizzolongo, P. J. (1996). The Comprehensive Child Development Program and other early intervention program models. In Subgroups at Risk for Smoking 183 R. J. McMahon (Ed.), Preventing childhood disorders, substance abuse, and delinquency(pp. 48-64). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390-395.

    Article  PubMed  Google Scholar 

  • Program, The Fast Track (1992). A developmental and clinical model for the prevention of conduct disorder. Development and Psychopathology, 4(4), 509-527.

    Google Scholar 

  • Resnick, M.D., Bearman, P. S., Blum, R.W., Bauman, K. E., Harris, K. M., Jones, J., Tabor, J., Beuhring,T., Sieving, R. E., Shew,M., Ireland, M., Bearinger, L. H., & Udry, J. R. (1997). Protecting adolescents from harm: Findings from the National Longitudinal Study on Adolescent Health. JAMA, 278(10), 823-832.

    PubMed  Google Scholar 

  • Robinson, L. A., Klesges, R. C., Zbikowski, S. M., & Glaser, R. (1997). Predictors of risk for different stages of adolescent smoking in a biracial sample. Journal of Consulting and Clinical Psychology, 65(4), 653-662.

    Article  PubMed  Google Scholar 

  • Rohde, P., Lewinsohn, P. M., & Seeley, J.R. (1991, May). Comorbidity of unipolar depression: II. Comorbidity with other mental disorders in adolescents and adults. Journal of Abnormal Psychology, 100(2), 214-222.

    Google Scholar 

  • Rohde, P., Lewinsohn, P. M., & Seeley, J. R. (1996). Psychiatric comorbidity with problematic alcohol use in high school students. Journal of the American Academy of Child and Adolescent Psychiatry, 35(1), 101-109.

    Article  PubMed  Google Scholar 

  • Sieber, M. F., & Angst, J. (1990). Alcohol, tobacco and cannabis: 12-year longitudinal associations with antecedent social context and personality. Drug and Alcohol Dependence, 25(3), 281- 292.

    Article  PubMed  Google Scholar 

  • Simon, T. R., Sussman, S., Dent, C. W., Burton, D., et al.(1995). Prospective correlates of exclusive or combined adolescent use of cigarettes and smokeless tobacco: A replication-extension. Addictive Behaviors, 20(4), 517-524.

    Article  PubMed  Google Scholar 

  • Steinberg, D., & Colla, P. (1995). CART: Tree-structured nonparametric data analysis.San Diego: Salford Systems.

    Google Scholar 

  • Sussman, S., Dent, C. W., & Galaif, E. R. (1997). The correlates of substance abuse and dependence among adolescents at high risk for drug abuse. Journal of Substance Abuse, 9 ,241- 255.

    Article  PubMed  Google Scholar 

  • Tyas, S. L., & Pederson, L. L. (1998). Psychosocial factors related to adolescent smoking: A critical review of the literature. Tob Control, 7(4), 409-420.

    PubMed  Google Scholar 

  • USDHHS (1994). Preventing tobacco use among young people: A report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

    Google Scholar 

  • USDHHS (1998). Tobacco use among U.S. racial/ethnic minority groups: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

    Google Scholar 

  • Van Roosmalen, E. H., & McDaniel, S. A. (1992). Adolescent smoking intentions: Gender differences in peer context. Adolescence, 27(105), 87-105.

    PubMed  Google Scholar 

  • Westfall, P. H., Tobias, R. D., Rom, D., Wolfinger, R. D., & Hochberg, Y. (1999). Multiple comparisons and multiple tests using the SAS(R) system. Cary, NC: SAS Institute.

    Google Scholar 

  • Zhang, H. P., & Bracken, M. B. (1996). A tree-based two-stage risk factor analysis of spontaneous abortion. American Journal of Epidemiology, 144 ,989-996.

    PubMed  Google Scholar 

  • Zucker, R. (1994). Pathways to alcohol problems and alcoholism: A developmental account of the evidence for multiple alcoholisms and for contextual contributions to risk. In G. Boyd (Ed.), The development of alcohol problems: Exploring the biopsychosocial matrix of risk (pp. 255-289). Rockville, MD: National Institute on Alcohol Abuse and Alcoholism.

    Google Scholar 

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  1. Department of Psychology, Wesleyan University, Middletown, Connecticut

    Lisa C. Dierker, Shelli Avenevoli, Abbie Goldberg & Meyer Glantz

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  1. Lisa C. Dierker
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Dierker, L.C., Avenevoli, S., Goldberg, A. et al. Defining Subgroups of Adolescents at Risk for Experimental and Regular Smoking. Prev Sci 5, 169–183 (2004). https://doi.org/10.1023/B:PREV.0000037640.66607.6b

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