A Latent Class Analysis of Vaping, Substance Use and Asthma Among U.S. High School Students: Results from the Center for Disease Control's Youth Risk Behavior Survey

Abstract

Rates of vaping among high school students have increased significantly over the past decade. Prior research has found significant associations between youth vaping and substance use. However, little is known about how vaping is associated with various patterns of polysubstance use and asthma in youth. We aimed to identify how youth are best categorized into classes based on co-occurring vaping and polysubstance use behaviors, how these classes are associated with youth background and demographic characteristics, and if these classes significantly predict asthma outcomes. Our sample consisted of nationally representative data from the 2017 and 2019 waves of the Youth Risk Behavior Survey (N = 28,442). We utilized Latent Class Analysis, multinomial logistic regression analyses, and binary logistic regression analyses to examine relationships between youth vaping, polysubstance use, and asthma. Three latent classes of substance use were identified: Polysubstance Users, Lifetime Alcohol and Vape Users, and Abstainers. Age, gender, grade and race were all significantly associated with odds of membership in the Polysubstance Users class, compared to the Abstainers class. Sexual identity was not associated with class membership. Membership in the Polysubstance Users class was significantly associated with higher odds of asthma, as compared to membership in the other two classes. These findings indicate that recent vaping is associated with high probabilities of recent polysubstance use. They also suggest that youth with high probabilities of vaping and polysubstance use are at significantly high risk for asthma compared to other classes vi of youth users and non-users. We recommend that future youth intervention strategies be tailored differently toward different classes of substance use and vaping. Future research should examine how the classes of vaping and substance use that we identify emerge in youth and what social factors (e.g., peer behavior, parental connectedness, etc.) influence their development.