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Alternative tobacco use among adolescents who smoke cigarettes is a growing public health concern, and evidence suggests that patterns of alternative tobacco use varies with respect to cigarette consumption and frequency of cigarette use. This study aimed to examine (a) whether variations in adolescent cigarette smoking and alternative tobacco use can be explained by underlying subtypes and (b) if these subtypes differ in their demographic and psychosocial characteristics.

Using data from the 2009 National Youth Tobacco Survey, latent class analysis (LCA) was used to identify patterns of cigarette smoking and alternative tobacco use among 2746 current (past 30-day) smokers. After identification, classes were analyzed using multinomial logistic regression to examine differences based on demographics and smoking-related characteristics.

Four of the six latent …