Latent Trajectories and Profiles of Commercial Cigarette Smoking Frequency From Adolescence to Young Adulthood Among North American Indigenous People

Abstract

Introduction North American Indigenous people (ie, American Indian/Alaska Native and Canadian First Nations) have the highest rates of commercial cigarette smoking, yet little is known about long-term trajectories of use among this population. The purpose of this study is to examine heterogeneous trajectories and profiles of Indigenous cigarette use frequency from early adolescence (mean age: 11.1 years) to young adulthood (mean age: 26.3 years). Aims and Methods Data come from a nine-wave prospective longitudinal study spanning early adolescence through young adulthood among Indigenous people in the Upper Midwest of the United States and Canada (N = 706). Smoking frequency was examined at each wave, and latent class growth analysis was used to examine heterogeneous patterns. Early adolescent and young adult demographics and smoking-related characteristics were examined across these latent trajectory groups. Results In young adulthood, 52% of participants smoked daily/near-daily, and an additional 10% smoked weekly or monthly. Four latent trajectory groups emerged: low/non-smokers (35.2%) who had low probabilities of smoking across the study; occasional smokers (17.2%) who had moderate probabilities of smoking throughout adolescence and declining probabilities of smoking into young adulthood; mid-adolescent onset smokers (21.6%) who showed patterns of smoking onset around mid-adolescence and escalated to daily use in young adulthood; and early-adolescent onset smokers (25.9%) who showed patterns of onset in early adolescence and escalated to stable daily use by late adolescence. Conclusions The findings suggest multiple critical periods of smoking risk, as well as a general profile of diverse smoking frequency patterns, which can inform targeted intervention and treatment programming. Implications Nearly two-thirds (62%) of this sample of Indigenous people were current smokers by early adulthood (mean age = 26.3 years), which is substantially higher than national rates in the United States and Canada. Moreover, in all but one trajectory group, smoking prevalence consistently increased over time, suggesting these rates may continue to rise into adulthood. The longitudinal mixture modeling approach used in this study shows that smoking patterns are heterogeneous, and implications for public health policy likely vary across these diverse patterns characterized by timing of onset of use, escalation in frequency of use, and stability/change over time.

Smoking across adolescence and adulthood with cardiovascular risk among American Indian peoples.

“…Caregiver Smoking. Caregivers indicated whether adolescents lived with caregivers who smoked (no[0]/yes[1]), a risk factor for smoking in prior research (Vuolo & Staff, 2013), including among AI individuals (Hautala et al, 2020).…”

“…This ordinal smoking measure was used over a measure of recent smoking intensity to enhance our ability to capture light or intermittent smoking patterns, a common pattern among younger populations (Chassin et al, 2009). A similar ordinal smoking variable was used in another study on smoking trajectories among AI individuals (Hautala et al, 2020).…”

“…Further, female gender, greater life stress, and higher deviant peer influences predicted membership in the occasional smokers class (Whitesell et al, 2014). Second, Hautala and colleagues (2020) examined smoking across ten waves spanning from ages 10–12 through ages 24–27 years-old among an Indigenous sample ( N = 708) living on/near four reservations in the upper-Midwest United States and Canada. Four smoking classes emerged, with the first two representing low levels of smoking: the low/nonsmokers class (35%) who largely reported no smoking; and the occasional smokers class (17%) who had increased smoking across adolescence followed by a reduction in adulthood.…”

“…The aforementioned longitudinal studies identified significant heterogeneity in smoking patterns among AI/Indigenous populations, with results indicating between three and four smoking classes (Hautala et al, 2020; Whitesell et al, 2014). These studies also identified important multilevel risk and health promotive factors related to smoking patterns among AI populations.…”

The association of chronotype, sleep duration and trajectories of health-risk behaviors among college students: a cohort study

“…Using data from the Health Survey for England, the research found that in 2008, the proportion of men with four multiple risk behaviors in the 16-24 age group was 6.7%, and the proportion of women was 5.7% [9]. Some studies try to describe the changes in HRBs with the age of adolescents [10], but most trajectory models focus on describing a single risk behavior. According to the risk accumulation hypothesis, exposure to multiple HRBs may lead to long-term health disadvantages [11], highlighting the need for greater knowledge about developmental trajectories of HRBs.…”