Paths to tobacco abstinence: A repeated-measures latent class analysis.

Abstract

Objective Knowledge of smoking change processes may be enhanced by identifying pathways to stable abstinence. We sought to identify latent classes of smokers based on their day-to-day smoking status in the first weeks of a cessation attempt. We examined treatment effects on class membership and compared classes on baseline individual differences and 6-month abstinence rates. Method In this secondary analysis of a double-blind randomized placebo-controlled clinical trial (N=1433) of 5 smoking cessation pharmacotherapies (nicotine patch, nicotine lozenge, bupropion SR, patch and lozenge, or bupropion SR and lozenge), we conducted repeated measures latent class analysis of daily smoking status (any smoking vs. none) for the first 27 days of a quit attempt. Treatment and covariate relations with latent class membership were examined. Distal outcome analysis compared confirmed 6-month abstinence rates among the latent classes. Results A 5-class solution was selected. Three-quarters of smokers were in stable smoking or abstinent classes, but 25% were in classes with unstable abstinence probabilities over time. Active treatment (compared to placebo), and particularly the patch and lozenge combination, promoted early quitting. Latent classes differed in 6-month abstinence rates and on several baseline variables, including nicotine dependence, quitting history, self-efficacy, sleep disturbance, and minority status. Conclusions Repeated measures latent class analysis identified latent classes of smoking change patterns affected by treatment, related to known risk factors, and predictive of distal outcomes. Tracking behavior early in a change attempt may identify prognostic patterns of change and facilitate adaptive treatment planning.

Patterns of youth tobacco and polytobacco usage: The shift to alternative tobacco products

“…The derived latent classes consist of probabilities of indicator endorsement. LCA has been used increasingly in drug dependence epidemiology, 19–23 and with polytobacco usage specifically based on the 2009 wave of the National Youth Tobacco Survey (NYTS) 24 and the 2010–2011 follow-up wave of the Minnesota Adolescent Community Cohort (MACC). 25 Although useful, these prior analyses require updating, given the rapid changes in the tobacco landscape.…”

How Much Is Too Much? Patterns of Drinking During Alcohol Treatment and Associations With Post-Treatment Outcomes Across Three Alcohol Clinical Trials

“…To identify discrete drinking patterns, we used a person-centered statistical approach (Muthén & Muthén, 2000)-repeated-measures latent class analysis (RMLCA) (Lanza & Collins, 2006;McCarthy et al, 2015)-that could accommodate weekly indicators of drinking across multiple weeks of treatment. RMLCA is a latent class model in which the indicators of the latent class are repeated measures.…”

Patterns of high-intensity drinking among young adults in the United States: A repeated measures latent class analysis

“…No functional form over time (such as quadratic growth) is assumed in RMLCA, allowing discontinuous patterns of use over time to be modeled (Lanza & Collins, 2006). For example, RMLCA has been used to model longitudinal change in past 12-month alcohol use among adolescents (Feldman, Masyn, & Conger, 2009), 6+ drinks per month among adults (Lanza & Collins, 2006), and daily smoking status among adults (McCarthy, Ebssa, Witkiewitz, & Shiffman, 2015). The methodology is highly appropriate for efforts to characterize longitudinal patterns of young adult high- intensity drinking.…”