{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T01:03:04Z","timestamp":1760576584759,"version":"build-2065373602"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["DMS2002865"],"award-info":[{"award-number":["DMS2002865"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007698","name":"University of Florida","doi-asserted-by":"publisher","award":["AI-2023-02"],"award-info":[{"award-number":["AI-2023-02"]}],"id":[{"id":"10.13039\/100007698","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Hidden Markov models (HMMs) are widely used to characterize latent state transition patterns in substance use. However, traditional HMM frameworks are incompetent when dealing with the complexities introduced by high-dimensional risk factors and varying time intervals, particularly in determining the number of hidden states and selecting variables for state transition parameters. To tackle the analytical challenges in the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative longitudinal cohort study on tobacco use, we propose a continuous-time HMM framework with a regularization algorithm to identify multi-dimensional risk factors underlying complex poly-tobacco use transitions. We develop an elastic-net regularization on the transition covariates to identify informative covariates and improve model estimation accuracy. The inclusion of key covariates enables accurate determination of the number of hidden states. We incorporate survey weights and information on strata and clustering throughout the modeling framework. We demonstrate the validity of our approach in determining state numbers, identifying informative covariates, and estimating model parameters through a series of simulations. Application of the proposed approach to PATH data analysis revealed several demographic, behavioral, and psychosocial factors that contribute to the differential risks of transition between tobacco-use states among youth and young adults. The model\u2019s capacity in identifying high-dimensional risk factors for underlying hidden variables substantiates its potential for enhancing public health research and informing interventions.<\/jats:p>","DOI":"10.1093\/biomtc\/ujaf138","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T20:30:45Z","timestamp":1760560245000},"source":"Crossref","is-referenced-by-count":0,"title":["A regularized continuous-time hidden Markov model for identifying latent state transition patterns of poly-tobacco use"],"prefix":"10.1093","volume":"81","author":[{"given":"Xinyu","family":"Yan","sequence":"first","affiliation":[{"name":"University of Florida Department of Biostatistics, , Gainesville, FL 32611 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji-Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Florida Department of Biostatistics, , Gainesville, FL 32611 ,","place":["United States"]},{"name":"Division of Quantitative Sciences, University of Florida Health Cancer Center , Gainesville, FL 32610 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8305-827X","authenticated-orcid":false,"given":"Xiang-Yang","family":"Lou","sequence":"additional","affiliation":[{"name":"University of Florida Department of Biostatistics, , Gainesville, FL 32611 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"2025101516303473500_bib1","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1111\/add.16095","article-title":"Longitudinal transitions in adolescent polytobacco use across waves 1\u20134 of the Population Assessment of Tobacco and Health Study","volume":"118","author":"Blank","year":"2023","journal-title":"Addiction (Abingdon, England)"},{"key":"2025101516303473500_bib2","doi-asserted-by":"crossref","DOI":"10.1201\/9781315139470","volume-title":"Classification and Regression Trees","author":"Breiman","year":"2017"},{"key":"2025101516303473500_bib3","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1136\/tobaccocontrol-2020-055967","article-title":"Transitions between cigarette, ENDS and dual use in adults in the PATH Study (waves 1\u20134): multistate transition modelling accounting for complex survey design","volume":"31","author":"Brouwer","year":"2022","journal-title":"Tobacco Control"},{"key":"2025101516303473500_bib4","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/s00180-007-0097-1","article-title":"Selecting hidden Markov model state number with cross\u2013validated likelihood","volume":"23","author":"Celeux","year":"2008","journal-title":"Computational Statistics"},{"key":"2025101516303473500_bib5","volume-title":"The Theory of Stochastic Processes","author":"Cox","year":"1977"},{"key":"2025101516303473500_bib6","doi-asserted-by":"crossref","first-page":"107548","DOI":"10.1016\/j.addbeh.2022.107548","article-title":"Longitudinal transitions in tobacco use in youth and young adults: a latent transition analysis of the PATH Study from Wave 1 to 5","volume":"138","author":"Huang","year":"2023","journal-title":"Addictive Behaviors"},{"key":"2025101516303473500_bib7","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1136\/tobaccocontrol-2016-052934","article-title":"Design and methods of the Population Assessment of Tobacco and Health (PATH) Study","volume":"26","author":"Hyland","year":"2017","journal-title":"Tobacco Control"},{"key":"2025101516303473500_bib8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v038.i08","article-title":"Multi\u2013state models for panel data: the msm package for R","volume":"38","author":"Jackson","year":"2011","journal-title":"Journal of Statistical Software"},{"key":"2025101516303473500_bib9","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1080\/01621459.1985.10478195","article-title":"The analysis of panel data under a Markov assumption","volume":"80","author":"Kalbfleisch","year":"1985","journal-title":"Journal of the American Statistical Association"},{"key":"2025101516303473500_bib10","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3102\/10769986013004299","article-title":"Manifest and latent Markov chain models for categorical panel data","volume":"13","author":"Langeheine","year":"1988","journal-title":"Journal of Educational Statistics"},{"key":"2025101516303473500_bib11","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s11222-015-9620-3","article-title":"Markov\u2013switching generalized additive models","volume":"27","author":"Langrock","year":"2017","journal-title":"Statistics and Computing"},{"key":"2025101516303473500_bib12","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1002\/sim.4780141804","article-title":"Multi\u2013state models and diabetic retinopathy","volume":"14","author":"Marshall","year":"1995","journal-title":"Statistics in Medicine"},{"key":"2025101516303473500_bib13","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1137\/S00361445024180","article-title":"Nineteen dubious ways to compute the exponential of a matrix, twenty-five years later","volume":"45","author":"Moler","year":"2003","journal-title":"SIAM Review"},{"key":"2025101516303473500_bib14","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1037\/met0000486","article-title":"Ten frequently asked questions about latent transition analysis","volume":"28","author":"Nylund-Gibson","year":"2023","journal-title":"Psychological Methods"},{"key":"2025101516303473500_bib15","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s11634-015-0205-y","article-title":"A uniform framework for the combination of penalties in generalized structured models","volume":"11","author":"Oelker","year":"2017","journal-title":"Advances in Data Analysis and Classification"},{"key":"2025101516303473500_bib16","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1177\/1471082X211008014","article-title":"A regularized hidden Markov model for analyzing the \u201chot shoe\u201d in football","volume":"22","author":"\u00d6tting","year":"2022","journal-title":"Statistical Modelling"},{"key":"2025101516303473500_bib17","doi-asserted-by":"crossref","first-page":"4407","DOI":"10.1175\/JCLI-3216.1","article-title":"Downscaling of daily rainfall occurrence over northeast Brazil using a hidden Markov model","volume":"17","author":"Robertson","year":"2004","journal-title":"Journal of Climate"},{"key":"2025101516303473500_bib18","doi-asserted-by":"crossref","first-page":"109272","DOI":"10.1016\/j.drugalcdep.2022.109272","article-title":"Transitions in tobacco use profiles among adolescents: results from the PATH Study Waves 3 and 4","volume":"232","author":"Romm","year":"2022","journal-title":"Drug and Alcohol Dependence"},{"key":"2025101516303473500_bib19","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1111\/add.14828","article-title":"Transitions across tobacco use profiles among adolescents: results from the PATH Study Waves 1 and 2","volume":"115","author":"Simon","year":"2020","journal-title":"Addiction (Abingdon, England)"},{"key":"2025101516303473500_bib20","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1111\/biom.12536","article-title":"Hidden Markov latent variable models with multivariate longitudinal data","volume":"73","author":"Song","year":"2017","journal-title":"Biometrics"},{"key":"2025101516303473500_bib21","article-title":"Population Assessment of Tobacco and Health (PATH) Study Public\u2013Use Files","author":"US Department of Health and Human Services. National Institutes of Health. National Institute on Drug Abuse, and US Department of Health and Human Services. Food and Drug Administration. Center for Tobacco Products","year":"2023"},{"key":"2025101516303473500_bib23","article-title":"Population Assessment of Tobacco and Health (PATH) Study Special Collection Public\u2013Use Files","author":"US Department of Health and Human Services. National Institutes of Health. National Institute on Drug Abuse, and US Department of Health and Human Services. Food and Drug Administration. Center for Tobacco Products","year":"2023"},{"key":"2025101516303473500_bib22","article-title":"Population Assessment of Tobacco and Health (PATH) Study Restricted\u2013Use Files, User Guide","author":"US Department of Health and Human Services. National Institutes of Health. National Institute on Drug Abuse, and US Department of Health and Human Services. Food and Drug Administration. Center for Tobacco Products","year":"2023"},{"key":"2025101516303473500_bib24","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1002\/sim.3463","article-title":"Multiple indicator hidden Markov model with an application to medical utilization data","volume":"28","author":"Wall","year":"2009","journal-title":"Statistics in Medicine"},{"key":"2025101516303473500_bib25","doi-asserted-by":"crossref","first-page":"e454","DOI":"10.1002\/sta4.454","article-title":"K\u2013fold cross\u2013validation for complex sample surveys","volume":"11","author":"Wieczorek","year":"2022","journal-title":"Stat"},{"key":"2025101516303473500_bib26","doi-asserted-by":"crossref","first-page":"100346","DOI":"10.1016\/j.lana.2022.100389","article-title":"Exploring the dynamic transitions of polysubstance use patterns among Canadian youth using latent Markov models","volume":"16","author":"Yang","year":"2022","journal-title":"The Lancet Regional Health\u2013Americas"},{"key":"2025101516303473500_bib27","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/j.1467-9868.2005.00503.x","article-title":"Regularization and variable selection via the elastic net","volume":"67","author":"Zou","year":"2005","journal-title":"Journal of the Royal Statistical Society, Series B"}],"container-title":["Biometrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/biometrics\/article-pdf\/81\/4\/ujaf138\/64712590\/ujaf138.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/biometrics\/article-pdf\/81\/4\/ujaf138\/64712590\/ujaf138.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T20:30:48Z","timestamp":1760560248000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/biometrics\/article\/doi\/10.1093\/biomtc\/ujaf138\/8287037"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":27,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10,8]]}},"URL":"https:\/\/doi.org\/10.1093\/biomtc\/ujaf138","relation":{},"ISSN":["0006-341X","1541-0420"],"issn-type":[{"value":"0006-341X","type":"print"},{"value":"1541-0420","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,10,8]]},"article-number":"ujaf138"}}