Rethinking an assessment of nicotine dependence: a sex, gender and diversity analysis of the Fagerstrom Test for Nicotine Dependence (original) (raw)
Related papers
Addictive Behaviors, 2013
Despite widespread use, considerable literature has shown that the Fagerström Test for Nicotine Dependence (FTND; Heatherton et al., 1991) has questionable psychometric properties, generally reflecting relatively poor properties of reliability and validity. One factor that may be affecting the psychometric qualities of the scale is the use of a dichotomous, forced-choice response format for certain items, in which respondents are asked to answer each question with a Yes or No response. This scoring approach is especially problematic when used to measure dimensional constructs, such as nicotine dependence, in which a dimensional construct is forced into a categorical construct. The purpose of the current study was to examine whether revising the response format utilized in the FTND would lead to an enhancement in the psychometric properties of this scale. This question was examined by removing the forced-choice response criteria on items 2, 5, and 6 of the FTND and revising the response options to reflect a 4-point Likert response set (0 = never, 1 = sometimes, 2 = most of the time, 3 = always). Participants consisted of 343 smokers from the community. Results revealed that the revised scoring approach resulted in a significant incremental improvement in scale reliability and enhanced convergent validity, showing a stronger association with smoking outcomes than the FTQ or FTND. Findings are discussed in terms of recommendations for scale revision and usage.
Fagerstrom test for nicotine dependence vs heavy smoking index in a general population survey
BMC Public Health, 2009
Background: The Fagerström Test for Nicotine Dependence (FTND) is used for assessing nicotine dependence. A shorter test derived from the FTND used for the general population is the Heavy Smoking Index (HSI) (six questions vs. two). The objective of this study is to compare the validity of the HSI versus the FTND. Methods: A survey of tobacco use in the general population was carried out in the northern Spanish region of Galicia using both the FTND and the HSI to study a representative sample of 1655 daily smokers. The HSI was compared with the FTND, considered the gold standard. Measures of sensitivity, specificity and predictive values were calculated. Concordance between the tests was also established (Cohen's kappa). Results: Cohen's kappa showed good agreement between measures (Kappa = 0.7); specificity values were also high (Sp = 96.2%). Sensitivity analysis in females (Se = 62.3%) did not show good agreement. Conclusions: The HSI can be used as a reasonably good screening test in order to identify daily smokers with high nicotine dependence. Nevertheless, for populations or subpopulations having low nicotine dependence, such as women, the FTND is more reliable.
Tobacco Induced Diseases, 2022
INTRODUCTION Measuring the level of nicotine addiction among smokers is an integral part of enhancing smoking cessation as nicotine dependence is one of the barriers to smoking cessation. In this study, we compared the level of agreement between FTND and HSI in detecting high nicotine dependence among daily smokers. METHODS We collected data from participants of a public smoking cessation clinic in Selangor. A trained pharmacist conducted face-to-face interviews with 152 daily smokers using a structured validated questionnaire. Respondents were classified as having high nicotine dependence using both the HSI (score ≥4) and the FTND (score ≥6), and concordance between the two measures, kappa statistics and sensitivity, specificity of the HSI were then determined with the FTND classification as the reference standard. RESULTS The HSI had a substantial agreement with the FTND (Cohen's kappa=0.72) in measuring high levels of nicotine addiction, with good sensitivity (83.3%) and specificity (89.4%). CONCLUSIONS The findings suggest that the HSI can be used instead of the FTND in clinical-based investigations to screen for high nicotine dependence among daily smokers in the clinical setting.
Drug and alcohol …, 2007
Few studies have examined the psychometrics of smoking-related behavioral measures in schizophrenia and questions have been raised about the applicability to smokers with schizophrenia. We examined the reliability of the Fagerström Test for Nicotine Dependence (FTND), Minnesota Nicotine Withdrawal Scale (M-NWS), and the Tiffany Questionnaire for Smoking Urges (TQSU) for smokers with schizophrenia (SS; n = 151) and nonpsychiatric smokers (CS; n = 181) recruited into three studies with similar inclusion criteria. SS and CS did not differ on a number of demographic and smoking variables (e.g., age). SS reported higher carbon monoxide (CO) levels, plasma cotinine levels, FTND, M-NWS, and TQSU Factor 1 scores. The internal consistencies (Cronbach's α) of the smoking measures were found to be high and comparable between diagnostic groups for the FTND, M-NWS total scores, and TQSU Factor 2 (all α's > 0.70) but higher for the CS than SS for the TQSU Factor 1 (0.86 versus 0.79). Test-retest correlations were lower for SS than CS on the FTND (0.65 versus 0.82), TQSU Factor 1 (0.65 versus 0.79), and TQSU Factor 2 (0.69 versus 0.81), but did not differ between diagnostic groups for M-NWS (0.58 versus 0.64). Our findings suggest that these measures may be reliable for use in smokers with schizophrenia.
A study of the psychometric properties of the Fagestrom Test for Nicotine Dependence
Addictive Behaviors, 2003
A factor analysis of 772 Fagestrom Test for Nicotine Dependence (FTND) was performed in a population of French workers with STATISTICA software, utilizing tetrachoric correlations to account for the dichotomous responses of the FTND. Confirmatory factorial analysis found the two-factor solution recently proposed for the FTND to be unsatisfactory. An exploratory factorial analysis concluded that the best solution was monofactorial when Item 3 was deleted. A confirmatory factorial analysis of the FTND provided support for this monofactorial solution. With the deletion of Item 3, the FTND achieved a high internal consistency (Cronbach's a=.86). Thus, a revision of the FTND with the exclusion of Item 3 is proposed. This revised form of the FTND appears to assess a unidimensional construct indicating robust construct validity. D
Fagerstrom test for nicotine dependence: reliability in a Turkish sample and factor analysis
Tüberküloz ve toraks, 2004
Fagerstom Test for Nicotine Dependence (FTND) has often been used as a measure of physical dependence on nicotine. In this study, we aimed to verify the usefulness of FTND and Heaviness of Smoking Index (HSI) in a sample of Turkish smokers and present relationship among interrelated items in our Turkish version of FTND by factor analysis. One hundred sixty nine smokers, 104 (61.5%) males, 65 (38.5%) females smoker were administered the Turkish translation of FTND. Fifty-two current smokers selected randomly from 169 were administered the questionnaire for test- retest reliability analysis. The Turkish version of FTND had moderate reliability (Cronbach alpha: 0.56). One FTND item (question 3: hate- most to give up) performed poorly on construct reliability tests. Factor 1 was loaded by questions 1 (first cigarette after awakening), 4 (number of cigarettes per day), 5 (smoking status during the first hours), 6 (smoking if ill), 2 (refrain from smoking in forbidden places) and factor 2...
A Brief Overview of Different Nicotine Addiction Scales
International Journal of Social Rehabilitation
Substance abuse is a serious public health problem across the world and is one of the biggest curses that modernsociety is facing. The assessment of nicotine addiction has been considered as a key topic as research into tobaccoaddiction progresses. Improved measurement may be required to make progress in tobacco research. The way nicotineaddiction is defined and assessed can have an impact on the findings and interpretations of studies and clinical trials.The Fagerström Tolerance Questionnaire (FTQ) and its shorter counterpart, the Fagerström Test for NicotineDependence (FTND), are the most well-known measures in terms of history and have been utilised in clinical andresearch contexts. The Fagerström scales, on the other hand, were designed to assess physical tolerance and thus donot assess several important aspects of nicotine dependence, such as cravings, subjective compulsion to smoke,nicotine withdrawal, behavioural saliency, or behavioural automaticity, which are frequently reg...
Exploring brief measures of nicotine dependence for epidemiological surveys
Addictive Behaviors, 2003
A score6 in the Fagerström Test for Nicotine Dependence (FTND), identifying high nicotine dependence, was compared with three briefer classifications: (1) Item 4: heavy smoking (more than 30 cigarettes per day); (2) Item 1: high early smoking (smoking within 30 min of waking up); and (3) a score4 by combining Items 1 and 4. The FTND scores from 1642 smokers from five samples in the US and Spain were analyzed. Heavy smoking had low sensitivity. High early smoking had low specificity. A score4 by combining Items 1 and 4 had relatively good sensitivity (94%) and specificity (88%). Researchers needing definition of nicotine dependence briefer than FTND may want to only use Items 1 and 4 of FTND with a cutting score4. D