Indicators of Tobacco Dependence Among Youth: Findings From Wave 1 (2013–2014) of the Population Assessment of Tobacco and Health Study

• Published in: Nicotine & tobacco research 2023-08, Vol.25 (9), p.1565-1574
• Main Authors: Strong, David R, Glasser, Allison M, Leas, Eric C, Pierce, John P, Abrams, David B, Hrywna, Mary, Hyland, Andrew, Cummings, K Michael, Hatsukami, Dorothy K, Fong, Geoffrey T, Elton-Marshall, Tara, Sharma, Eva, Edwards, Kathryn C, Stanton, Cassandra A, Sawdey, Michael D, Ramôa, Carolina P, Silveira, Marushka L, Kimmel, Heather L, Niaura, Raymond S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Electronic Nicotine Delivery Systems; Humans; Original Investigations; Tobacco Products; Tobacco Use - epidemiology; Tobacco Use Disorder - epidemiology; United States
• ISSN: 1469-994X; 1462-2203; 1469-994X
• DOI: 10.1093/ntr/ntad072

Abstract Background Prior work established a measure of tobacco dependence (TD) among adults that can be used to compare TD across different tobacco products. We extend this approach to develop a common, cross-product metric for TD among youth. Methods One thousand one hundred and forty-eight youth aged 12–17 who used a tobacco product in the past 30 days were identified from 13 651 youth respondents in Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study. Findings Analyses confirmed a single primary latent construct underlying responses to TD indicators for all mutually exclusive tobacco product user groups. Differential Item Functioning analyses supported the use of 8 of 10 TD indicators for comparisons across groups. With TD levels anchored at 0.0 (standard deviation [SD] = 1.0) among cigarette only (n = 265) use group, mean TD scores were more than a full SD lower for e-cigarette only (n = 150) use group (mean = −1.09; SD = 0.64). Other single product use group (cigar, hookah, pipe, or smokeless; n = 262) on average had lower TD (mean = −0.60; SD = 0.84), and the group with the use of multiple tobacco products (n = 471) experienced similar levels of TD (mean = 0.14; SD = 0.78) as the cigarette only use group. Concurrent validity was established with product use frequency among all user groups. A subset of five TD items comprised a common metric permitting comparisons between youth and adults. Conclusion The PATH Study Youth Wave 1 Interview provided psychometrically valid measures of TD that enable future regulatory investigations of TD across tobacco products and comparisons between youth and adult tobacco product use group. Implications A measure of tobacco dependence (TD) has been established previously among adults to compare TD across tobacco products. This study established the validity of a similar, cross-product measure of TD among youth. Findings suggest a single latent TD construct underlying this measure, concurrent validity of the scale with product use frequency across different types of tobacco users, and a subset of common items that can be used to compare TD between youth and adults who use tobacco.