Limited research has examined polysubstance use profiles among young adults focusing on the various tobacco products currently available. We examined use patterns of various tobacco products, marijuana, and alcohol using data from the baseline survey of a multiwave longitudinal study of 3418 students aged 18-25 recruited from seven U.S. college campuses. We assessed sociodemographics, individual-level factors (depression; perceptions of harm and addictiveness,), and sociocontextual factors (parental/friend use). We conducted a latent class analysis and multivariable logistic regression to examine correlates of class membership (Abstainers were referent group). Results indicated five classes: Abstainers (26.1% per past 4-month use), Alcohol only users (38.9%), Heavy polytobacco users (7.3%), Light polytobacco users (17.3%), and little cigar and cigarillo (LCC)/hookah/marijuana co-users (10.4%). The most stable was LCC/hookah/marijuana co-users (77.3% classified as such in past 30-day and 4-month timeframes), followed by Heavy polytobacco users (53.2% classified consistently). Relative to Abstainers, Heavy polytobacco users were less likely to be Black and have no friends using alcohol and perceived harm of tobacco and marijuana use lower. Light polytobacco users were older, more likely to have parents using tobacco, and less likely to have friends using tobacco. LCC/hookah/marijuana co-users were older and more likely to have parents using tobacco. Alcohol only users perceived tobacco and marijuana use to be less socially acceptable, were more likely to have parents using alcohol and friends using marijuana, but less likely to have friends using tobacco. These findings may inform substance use prevention and recovery programs by better characterizing polysubstance use patterns.

INTRODUCTION Limited research has examined reasons for polytobacco use, an increasing public health problem, particularly among young adults. We examined reasons for polytobacco use among users of more than one tobacco product in the past 4 months enrolled in an ongoing sixwave longitudinal study of 3,418 students aged 18-25 from seven US colleges and universities. METHODS An expert panel generated items related to reasons for polytobacco use, included in Wave 3 (administered in Summer 2015). Participants reporting use of more than one tobacco product in the past four months (n=540) were asked to complete the Reasons for Polytobacco Use scale and measures related to tobacco/nicotine use/dependence, use motives, perceptions of tobacco, parental/friend use, other substance use, and mental health. We conducted a factor analysis and then examined convergent and discriminant validity for the derived factors. RESULTS Our sample was an average age of 20.40 (SD=1.84), 48.0% male, and 21.9% Black. Four factors were identified: Instrumentality, Social Context, Displacement, and Experimentation. Instrumentality was the only factor associated with little cigar/cigarillo and marijuana use. Displacement and Social Context showed similar associations; however, Social Context was associated with having friends who used tobacco while Displacement was not. Experimentation was associated with greater perceived addictiveness and harm of using tobacco products as well as greater perceived social acceptability of tobacco use. CONCLUSIONS Each of the four factors identified demonstrated unique convergent and discriminant validity. The use of this scale to characterize polytobacco using young adults may help inform and target cessation or prevention interventions.

Although smoking is a major risk factor for cancer, little is known about cancer patients' or survivors' views or concerns about smoking and quitting. This study used text mining of posts to an online community of cancer patients and survivors to investigate contexts in which smoking or quitting is discussed. Results indicated that smoking and quitting discussions were relatively rare, but nevertheless provide insight into barriers that may need to be addressed in cessation interventions for survivors.

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BackgroundWeb-based survey research has several benefits, including low cost and burden, as well as high use of the Internet, particularly among young adults. In the context of longitudinal studies, attrition raises concerns regarding the validity of data, given the potential associations with individual and institutional characteristics, or the focal area of study (eg, cigarette use).ObjectivesThe objective of this study was to compare baseline characteristics of nonresponders versus responders in a sample of young adult college students in a Web-based longitudinal study regarding tobacco use.MethodsWe conducted a secondary data analysis of 3189 college students from seven Georgia colleges and universities in a 2-year longitudinal study. We examined baseline tobacco use, as well as individual- and institutional-level factors, as predictors of attrition between wave 1 (October and November 2014) and wave 2 (February and March 2015) using multilevel modeling. Results: A total 13.14% (419/3189) participants were lost to follow-up at wave 2. Predictors of nonresponse were similar in the models examining individual-level factors and institutional-level factors only and included being black versus white (odds ratio [OR] 1.74, CI 1.23-2.46); being male versus female (OR 1.41, CI 1.10-1.79); seeking a bachelor’s degree versus advanced degree (OR 1.41, CI 1.09-1.83); not residing on campus (OR 0.62, CI 0.46-0.84); past 30-day tobacco use (OR 1.41, CI 1.10-1.78); attending a nonprivate college (OR 0.48, CI 0.33-0.71); and attending a college with ≤10,000 students (OR 0.56, CI 0.43-0.73).ConclusionsFuture longitudinal studies should assess predictors of attrition to examine how survey topic and other individual and institutional factors might influence the response to allow for correction of selection bias.