Examining the dynamics of tobacco dependence and psychosocial influences: A random intercept-latent transition analysis.

Current literature on tobacco dependence often overlooks the nuanced interplay between individual and psychosocial factors over time. This study employed Random Intercept-Latent Transition Analysis to examine the progression of tobacco dependence among established smokers, focusing on how demographic variables and psychosocial influences impact transitions between dependence levels. Data from the Population Assessment of Tobacco and Health Study across three waves (n = 12,823; 45.3% female) were analyzed. Four latent classes were identified: Stable Low Dependence, Increasing Dependence, Worsening Dependence, and Stable High Dependence. Younger individuals and Hispanic populations were more likely to progress to higher dependence levels, with family and peer influences linked to worsening dependence. These findings highlight the need for personalized, culturally sensitive interventions that address specific stages of tobacco dependence, informing more effective tobacco control strategies that consider both individual and contextual factors.