Author ORCID Identifier

https://orcid.org/0000-0001-7958-6953

Date of Award

12-2024

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr. Claire Adams-Spears

Second Advisor

Dr. Scott Weaver

Third Advisor

Dr. Katherine Masyn

Abstract

AIM: To characterize patterns of cigarette smoking exposures and social support in adolescents and examine their relationship with socioeconomic status.

METHODS: Using WAVE I data from the National Longitudinal Study of Adolescent to Adult Health (n=6,504 U.S. adolescents, grades 7-12, 1994-1995), latent class analysis identified patterns of smoking exposures and social context. Indicators included environmental exposures of parental and peer smoking influence and accessibility and social support factors of feeling cared for by parents and friends. Socioeconomic status was measured through maternal employment, education, and household income.

RESULTS: Latent class enumeration combined with substantive model utility revealed a semi-confirmatory 5-class model as best-fitting. Model fit indices supported reliable model data consistency and classification diagnostics demonstrated well separated and precisely classified classes (E=0.973, n=6493). Key classes include 1) no environmental exposures and high social support (16.8%), 2) high environmental exposures and lower support (5.2%), 3) high parental and accessibility exposures, and high support (29.4%), 4) peer exposure and moderate support (18.8%), and 5) high parental exposure but no accessibility/exposure and high support (29.8%). Socioeconomic factors were significantly associated with class membership, with higher maternal education and household income predicting lower likelihood of being in the high exposure classes.

DISCUSSION: This study identified distinct patterns of smoking determinants in adolescents, highlighting the important role of socioeconomic factors in shaping these profiles. The findings suggest interventions may need to be tailored to address the unique needs of adolescent subgroups defined by environmental and social contexts.

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