Cigarette dependence questionnaire: development and psychometric testing with male smokers
ABSTRACT This paper is a report of a study conducted to develop and test a theoretically derived Cigarette Dependence Questionnaire for adult male smokers.
Fagerstrom questionnaires have been used worldwide to assess cigarette dependence. However, these assessments lack any theoretical perspective. A theory-based approach is needed to ensure valid assessment.
In 2007, an initial pool of 103 Cigarette Dependence Questionnaire items was distributed to 109 adult smokers in Taiwan. Item analysis was conducted to select items for inclusion in the refined scale. The psychometric properties of the Cigarette Dependence Questionnaire were further evaluated 2007-08, when it was administered to 256 respondents and their saliva was collected and analysed for cotinine levels. Criterion validity was established through the Pearson correlation between the scale and saliva cotinine levels. Exploratory factor analysis was used to test construct validity. Reliability was determined with Cronbach's alpha coefficient and a 2-week test-retest coefficient.
The selection of 30 items for seven perspectives was based on item analysis. One factor accounting for 44.9% of the variance emerged from the factor analysis. The factor was named as cigarette dependence. Cigarette Dependence Questionnaire scores were statistically significantly correlated with saliva cotinine levels (r = 0.21, P = 0.01). Cronbach's alpha was 0.95 and test-retest reliability using an intra-class correlation was 0.92.
The Cigarette Dependence Questionnaire showed sound reliability and validity and could be used by nurses to set up smoking cessation interventions based on assessment of cigarette dependence.
- [Show abstract] [Hide abstract]
ABSTRACT: Research showed that the widely used Fagerstrom test for nicotine dependence (FTND) does not cover important aspects of dependence. A new test, the cigarette dependence scale (CDS-12), covers the main elements in DSM-IV and ICD-10 definitions of dependence. We compared the psychometrics of CDS-12, FTND, and CDS-5 and the heaviness of smoking index (HSI), which are short versions of CDS-12 and FTND, respectively. Internet survey in 2002-2003. Participants were invited one month after answering the first survey to answer a second survey on smoking status and withdrawal symptoms. Eight hundred two smokers answered both surveys. Cronbach's alpha coefficients were higher for CDS-12 (0.91) and CDS-5 (0.77) than for FTND (0.68) and HSI (0.63). Among 231 smokers who quit smoking at follow-up, higher baseline CDS-12 scores predicted higher withdrawal ratings at follow-up, for all withdrawal symptoms except appetite. FTND and HSI predicted higher craving in quitters, but did not predict the intensity of other withdrawal symptoms. Neither CDS-5, FTND or HSI predicted smoking cessation, but higher CDS-12 scores marginally predicted smoking cessation at follow-up (area under the receiver operating characteristic (ROC) curve = 0.55, 95% confidence interval = 0.51-0.59). CDS-12 had better content validity and internal consistency than FTND and was a slightly better predictor of withdrawal symptoms. Unexpectedly, higher (not lower) CDS-12 scores predicted subsequent smoking cessation, perhaps because endorsement of some CDS-12 items implies accepting that one is dependent, which in turn could reflect motivation to quit. CDS-12 may represent an alternative to FTND for measuring cigarette dependence.Drug and Alcohol Dependence 04/2005; 77(3):259-68. DOI:10.1016/j.drugalcdep.2004.08.015 · 3.28 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: To compare the concurrent and predictive validities of two subsets of DSM-IV criteria for nicotine dependence (tolerance and withdrawal; withdrawal; difficulty controlling use; and use despite harm) to the concurrent and predictive validity of the full DSM-IV criteria. Analysis of baseline and outcome data from three randomized clinical trials of cigarette smoking treatment. San Francisco, California. Two samples of cigarette smokers (n = 810 and 322), differing with regard to baseline characteristics and treatment received, derived from three randomized clinical trials. DSM-IV nicotine dependence criteria were measured at baseline with a computerized version of the Diagnostic Interview Schedule for DSM-IV (DIS-IV). Additional baseline measures included the Fagerström Test of Nicotine Dependence (FTND), number of cigarettes smoked per day, breath carbon monoxide (CO) level, the Minnesota Nicotine Withdrawal Scale (MNWS), the Michigan Nicotine Reinforcement Questionnaire (M-NRQ) and the Profile of Mood States (POMS). Seven-day point-prevalence abstinence was assessed at week 12. Full DSM-IV criteria displayed greater concurrent validity than either of the two subsets of criteria. However, DSM-IV symptoms accounted for only a nominal amount of the variance in baseline smoking-related characteristics and were unrelated to smoking abstinence at week 12. Cigarettes smoked per day was the only significant predictor of abstinence at week 12. Although the findings do not provide a compelling alternative to the full set of DSM-IV nicotine dependence criteria, its poor psychometric properties and low predictive power limit its clinical and research utility.Addiction 08/2008; 103(7):1215-23. DOI:10.1111/j.1360-0443.2008.02232.x · 4.60 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: This study examined the relationship of nicotine dependence with smoking cessation and major depression, using the Fagerstrom Test for Nicotine Dependence (FTND) and the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R). In an epidemiologic study of young adults that used the FTND and the National Institute of Mental Health Diagnostic Interview Schedule, 238 daily smokers were assessed with respect to nicotine dependence. Cessation (abstinence for 1 year or more) was assessed 2 years later. FTND-defined nicotine dependence predicted cessation, with non-dependent smokers 4 times more likely to quit. DSM-III-R-defined nicotine dependence also predicted cessation, but much more weakly. Number of cigarettes per day was the best predictor of cessation. FTND-defined dependence was unrelated to major depression, whereas DSM-III-R-defined dependence signaled a 3-fold risk for major depression. The association of DSM-III-R-defined nicotine dependence with major depression might be driven by the behavioral rather than the physiologic symptoms of dependence. The more a measure of dependence is based exclusively on level of daily smoking, the greater is its ability to predict cessation. The number of DSM-III-R behavioral symptoms might be an indicator of severity of dependence or of personality traits, which in turn might be associated with major depression.American Journal of Public Health 08/2000; 90(7):1122-7. DOI:10.2105/AJPH.90.7.1122 · 4.23 Impact Factor