Prevention Science, Vol. 5, No. 3, September 2004 (
Defining Subgroups of Adolescents at Risk for
Experimental and Regular Smoking
Lisa C. Dierker,
and Meyer Glantz
If multiple etiologies of substance use are truly at work in the population, then further strides
in the accurate prediction of smoking and the use of other substances will likely be built on di-
verse pattern-centered approaches that explore the presence of multiple population subgroups
across various substance use stages. The present study aimed to identify population subgroups
deﬁned by individual risk factors or risk factor constellations that prospectively predict speciﬁc
smoking stages. Using data from the National Longitudinal Study of Adolescent Health (Add
Health), analyses were conducted on the sample that took part in the baseline and 1 year
follow-up assessment between 1994 and 1996. Classiﬁcation and regression tree procedures
were used to investigate the structure of individual risk factors, or constellations of risk, that
deﬁne population subgroups with high rates of both experimental and established smoking.
For each level of smoking, a relatively simple model including two subgroups predicted over
half of the smoking cases. Findings also indicated that the two group models identiﬁed higher
rates of regular smokers compared to experimental smokers. Deviant behaviors and alcohol
use without permission independently predicted movement to experimentation at follow-up.
Progression to regular smoking from both a nonsmoking and experimental smoking status at
baseline were each predicted by smoking friends. Additionally, baseline levels of experimental
use predicted movement from experimental to regular smoking, while a relatively low grade
point average predicted rapid progression from baseline nonuse to regular use at follow-up.
By identifying ﬁrst approximations of patterns, these analyses may lead to clues regarding the
major multiple mechanisms at work for the progression of smoking among adolescents.
KEY WORDS: smoking; risk factors; substance use; adolescents.
The goal of risk factor research focusing on sub-
stance use and a wide variety of other negative out-
comes is to inform the content and timing of efforts
Department of Psychology, Wesleyan University, Middletown,
Mood and Anxiety Disorders Program, Intramural Research Pro-
gram, Department of Health and Human Services, National In-
stitute of Mental Health, National Institutes of Health, Bethesda,
University of Massachusetts, Amherst, Massachusetts.
Division of Epidemiology, Services and Prevention Research, Na-
tional Institute of Drug Abuse, Bethesda, Maryland.
Correspondence should be directed to Dr. Lisa C. Dierker, De-
partment of Psychology, Wesleyan University, 207 High Street,
Middletown, Connecticut 06459; e-mail: email@example.com.
aimed at preventing the onset and/or escalation of
these conditions (IOM, 1996; Mrazek & Haggerty,
1994). The added focus on informing the appropriate
human targets of prevention has similarly emerged
from decades of risk factor research demonstrating
a wide variety of potent predictors (for a review see
Hawkins et al., 1992), but no single risk factor or con-
stellation that is necessary or sufﬁcient for the devel-
opment of substance use, abuse, or dependence. Re-
cent targeted prevention programs intended in full or
in part to reduce rates of substance use have com-
monly aimed their efforts at “high-risk groups” de-
ﬁned by early signs/symptoms demonstrated in previ-
ous risk research [e.g. children of substance abusing
parents (Kumpfer et al., 1996), deviant youth
(McMahon & Slough, 1996), and adolescents from im-
poverished socioeconomic backgrounds (Pizzolongo,
2004 Society for Prevention Research