Distinct social and psychological risk patterns define latent classes associated with smoking susceptibility in never-smoking adolescents and young adults

Smoking-related cognitions are relevant to understanding tobacco prevention needs during adolescence and young adulthood. This study aimed to identify latent classes of adolescents and young adults who had never tried cigarettes based on social and psychological factors associated with smoking susceptibility and to examine their association with the Expanded Susceptibility to Smoking Index (ESSI). A cross-sectional study was conducted with 597 participants aged 12–22 years recruited from educational institutions in Extremadura, Spain, who reported never having tried cigarettes. Indicators of social exposure to tobacco (family, peers, classmates, and tobacco offers) and psychological factors (impulsivity, positive and negative affect, and emotion regulation) were used in the latent class analysis. Multinomial logistic regression was used to examine the associations between latent class membership and ESSI levels, adjusting for age, sex, and socioeconomic status. Three latent classes were identified. The lowest-risk class had low probabilities across indicators and included the largest proportion of nonsusceptible participants. Class 2 was defined by high social exposure to tobacco, and Class 3 by intermediate social exposure combined with high impulsivity and elevated negative affect. Both were associated with high susceptibility to smoking, to a similar degree (adjusted OR 5.00, 95% CI 2.84–8.79 and 6.01, 95% CI 2.79–12.90, respectively). Thus, among adolescents and young adults who have never tried cigarettes, distinct psychosocial profiles were associated with different levels of smoking susceptibility, which may support the development of more targeted prevention strategies.