Latent Structure of Past 12-Month Tobacco Use in Wave 6 of the Population Assessment of Tobacco and Health: Examining for Differential Substructure by Generational Status

Subst Use Misuse. 2025;60(8):1173-1180. doi: 10.1080/10826084.2025.2491769. Epub 2025 Apr 22.

Abstract

Introduction: Tobacco product usage patterns vary significantly across different segments of the population. Combustible tobacco product usage decreased from 19.3% to 12.5%, while electronic cigarette (ECIG) use rose from 1.8% to 3.7% for the US population from 2010 to 2020. However, age-specific estimates differ between younger and older adults. It is possible there are latent subpopulations within American adults.

Method: Data from Wave 6 of the Population Assessment of Tobacco and Health survey (PATH, N = 30,516) were analyzed. Participants were classified as a member of Generation Z (N = 10,920), Millennials (N = 10,450), Generation X (N = 6122), or Baby Boomers (N = 3024) via a 6-level ordinal variable collected by PATH. Latent class analysis (LCA) identified distinct groups based on 8 tobacco use variables.

Results: Analysis suggests that a 4-class solution provides the optimal solution for the entire sample. These classes comprised of a low-use class, a high-use class, ECIG Plus (defined as ECIG use with less probability of other tobacco product use), and a conventional user class, defined as high probability on conventional tobacco products. A 4-class solution also provided optimal fit for each generation, though the classes were defined differently.

Discussion: Understanding tobacco use patterns across different classes is crucial for public health interventions. The discovery of a possible class of social users among Generation Z and Millennials suggests that targeted interventions tailored to the social contexts and behaviors of younger generations may be effective while pharmacological treatments may be more efficacious for Baby Boomers.

Keywords: Tobacco use patterns; generational status; latent class analysis.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Electronic Nicotine Delivery Systems / statistics & numerical data
  • Female
  • Health Surveys
  • Humans
  • Latent Class Analysis
  • Male
  • Middle Aged
  • Tobacco Use* / epidemiology
  • United States / epidemiology
  • Young Adult