Changes in tobacco use patterns among adolescents in substance abuse treatment

The purpose of this study was to determine tobacco use and dependence patterns over the course of 12 months among an adolescent population entering substance abuse treatment. The sample consisted of intake and 3-, 6-, and 12-month post-intake tobacco use data from 1062 adolescents within 34 substance abuse treatment facilities across the United States. Data were pooled across sites and analyzed utilizing descriptive statistics; repeated measures analyses; multiple regression models; three-level hierarchical linear models; and hierarchical generalized linear modeling. The majority of the sample reported at least weekly tobacco use at intake. Over time, participants increased their total tobacco consumption and days of use while reporting less desire for help with cessation. Race/ethnicity was a factor in differing tobacco use patterns. Tobacco dependence rates remained stable from intake to 3 months post-intake, decreased at 6 months post-intake, and rose to its highest levels at 12 months post-intake. Participants attended one smoking cessation class on average in each 90 day time period. Results suggest that adolescents entering substance use treatment may benefit from integrated tobacco cessation interventions that are intensive and occur early in treatment.