Tobacco use and suicidality: Latent patterns of co-occurrence among black adolescents

Introduction: Tobacco use is responsible for a considerable portion of the health disparities experienced by Blacks. In addition to its physiological effects, tobacco use has consistently been shown to be associated with suicidality among adolescents. The purpose of the present study is to describe the association between specific patterns of tobacco use behavior and those of suicidality among a nationally representative sample of Black high school students. Methods: Responses from Black adolescents (N = 2,931) who completed the 2007 Youth Risk Behavior Surveillance Survey were included. Latent class analysis was utilized to identify typologies based on two domains: (a) lifetime and recent tobacco use and (b) suicidality. The association between tobacco use class membership and suicidality class membership as well as the direct effects of age and gender on class membership was also investigated. Results: A significant proportion of Black youth reported smoking and suicidal behaviors. A 4-class model provided the best overall fit to the data for tobacco use behavior (nonsmokers, former smokers, light current smokers, and frequent current smokers); a 3-class model provided the best overall fit to the data for suicidality (not suicidal, mild suicidality, suicidal). Smoking status was associated with suicidality class membership, with more intense patterns of smoking related to increased probability of identification with both mild suicidality and being classified as suicidal compared with not suicidal. Conclusions: The results of this study indicate that any current smoking status increases the likelihood of suicidality at least 5-fold and provides incentive to target this specific portion of the population of Black adolescent smokers.