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Nicotine Tob Res. 2003 Oct;5(5):625-33.

A comparison of self-report measures of nicotine dependence among male drug/alcohol-dependent cigarette smokers.

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American Institutes for Research and Palo Alto Veterans Affairs Health Care System, Palo Alto, CA 94304, USA.


This study examined the psychometric properties and validity of the Fagerström Tolerance Questionnaire (FTQ), the Fagerström Test for Nicotine Dependence (FTND), and the Heaviness of Smoking Index (HSI) when used as self-report measures of nicotine dependence among male drug/alcohol-dependent smokers (n=191 participants in a large stop-smoking study). All three measures had fairly low internal consistency. The FTQ and FTND had similar two-factor structures, but the FTND factor structure accounted for a greater percentage of the item variance. All three measures were significantly correlated in the expected directions with several independent self-report and biochemical indicators of nicotine dependence (e.g., cigarette pack-years, cotinine) and with baseline measures of smoking topography. The FTND outperformed the FTQ on several correlations, and the HSI outperformed both the FTQ and the FTND. Results concerning correlations between each of the three measures and indicators of compensation in response to reductions in nicotine availability were equivocal. The HSI and FTND were predictive of at least 4 weeks of biochemically verified postquit abstinence among a subsample of individuals receiving smoking treatment (n=93). All three measures had mediocre psychometric properties, and the magnitudes of their relationships with independent indicators were generally modest. All three measures appeared to be valid as self-report measures of nicotine dependence among male drug/alcohol-dependent individuals. The HSI appeared to be the best of the three measures; thus, studies of drug/alcohol-dependent smokers should be sure to report the results from this measure. Efforts to develop self-report measures of nicotine dependence with better properties and performance in this population should continue to be pursued.

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