A Latent Class Analysis of Smokeless Tobacco Use in the United States.

While there has been an escalating trend in the number of smokeless tobacco uses, mainly snuff, in the United States, it is unclear whether smokeless tobacco users are a homogenous class. The present investigation examines this question and identifies subtypes of smokeless tobacco users in order to better understand the characteristics of these individuals and guide appropriate intervention. Data on smokeless tobacco users (N = 2504) derived from the National Epidemiologic Survey on Alcohol and Related Conditions was employed. A range of antisocial behaviors, from reflecting non-violent deviant acts, irresponsibility, and a disengaged lifestyle, to aggression and violence were used to estimate the number of subtypes of smokeless tobacco users using latent class analysis. Four latent classes emerged: Normative Class (50.2 %), Deviant Class (21.9 %), Disengaging Class (17.2 %), and Antisocial Class (10.5 %). Logistic regression shows that major depression, alcohol use disorder, and marijuana use disorder were associated with Deviant Class (OR's from 2.0 to 10.5). The same array of psychiatric disorders and general anxiety disorder were associated with greater odds of membership in the Disengaging Class (OR's from 2.6 to 7.4). Aforementioned psychiatric disorders and illicit drug use disorder were associated with the Antisocial Class (OR's from 3.8 to 38.1). Findings indicate that smokeless tobacco users are a heterogeneous population that may benefit from differential intervention strategies.