Identifying trajectories of adolescent smoking: an application of latent growth mixture modeling.

The goal of the current study was to identify discrete longitudinal patterns of change in adolescent smoking using latent growth mixture modeling. Five distinct longitudinal patterns were identified. A group of early rapid escalators was characterized by early escalation (at age 13) that rapidly increased to heavy smoking. A pattern characterized by occasional puffing up until age 15, at which time smoking escalated to moderate levels was also identified (late moderate escalators). Another group included adolescents who, after age 15, began to escalate slowly in their smoking to light (0.5 cigarettes per month) levels (late slow escalators). Finally, a group of stable light smokers (those who smoked 1-2 cigarettes per month) and a group of stable puffers (those who smoked only a few puffs per month) were also identified. The stable puffer group was the largest group and represented 25% of smokers.

Stages in the development of adolescent smoking.

Many researchers have conceptualized smoking uptake behavior in adolescence as progressing through a sequence of developmental stages. Multiple social, psychological, and biological factors influence this process, and may play different functions at different points in the progression, and play different roles for different people. The major objective of this paper is to review empirical studies of predictors of transitions in stages of smoking progression, and identify similarities and differences related to predictors of stages and transitions across studies. While a number of factors related to stage of progression replicated across studies, few variables uniquely predicted a particular stage or transition in smoking behavior. Subsequently, theoretical considerations related to stage conceptualization and measurement, inter-individual differences in intra-individual change, and the staged or continuous nature of smoking progression are discussed.