Among our many findings perhaps the most important is that, unlike previous studies, we identified two distinct groups of intermittent smokers, with low intermittent smokers differing sharply from high intermittent smokers and high intermittent smokers being distinctly different from daily smokers on most characteristics. However, for some characteristics high intermittent smokers aligned more closely with daily smokers and on others they represent a clear midpoint between daily smokers and low intermittent smokers. Interestingly, contrary to studies among the general adult population, intermittent smokers did not differ from daily smokers on age. This may be in part due to our sample being limited to young adults (a somewhat narrow age range).
In our final multivariate model, a high proportion of variance (70%) between levels of smoking is explained by our independent variables, with the addiction block explaining most of this variability. We also found that the addition of each block of independent variables explained additional variance, indicating that all the factors were important in distinguishing the three groups. Odds ratios further confirm the distinctions between groups. Clearly, tobacco prevention and treatment programs must not consider intermittent young adult smokers as one homogeneous group with the same characteristics and behaviors.
Furthermore, unlike previous studies that suggest many young adult intermittent smokers are social smokers, we found that nearly all of the low-intermittent smokers do not usually smoke when they are with friends, at bars, or at parties, and nearly one-third of the low and high intermittent smokers don’t even go to bars. Although our survey did not specifically ask if smoking is largely limited to social situations, high intermittent smokers may more closely resemble social smokers, as most usually smoke when they go to parties and about half usually smoke when they are at bars or with friends.
The tobacco industry has long known that the young adult period is the time when daily consumption of cigarettes increases until solidifying into heavy smoking as older adults (Ling & Glantz, 2002
). Our sample of 18–22 year-old adults exemplifies these unsettled smoking patterns, with roughly equal numbers in each group of low intermittent, high intermittent and daily smokers. Our data emphasize that it is important for researchers and intervention professionals to recognize the varied smoking patterns among this age group and how they differ from the more stable patterns of adult smokers and the experimental patterns of adolescents (Adelman, 2006
Several limitations should be noted. First, our sample is from the Midwestern U.S. which limits the generalizability to the U.S. as a whole and other countries. However, our sample, unlike others examining non-daily smoking among young adults, does include both college students and those not attending college, and includes participants from rural and urban regions. Secondly, we were not able to analyze how race/ethnicity differed among smoking groups of young adults because our sample was largely White. Finally, our study is cross-sectional which prevents us from determining how intermittent smoking patterns change over time.
Future studies are underway using MACC data to determine intermittent smoking patterns from adolescence through young adulthood. Our study provides valuable information to guide future studies on intermittent smoking, as well as to guide tobacco prevention and treatment professionals in addressing intermittent smoking patterns and behaviors among the young adult population, particularly given that intermittent smokers are at risk for escalation to more frequent and heavier smoking.