- Volume 13 Issue 6
DOI QR Code
Assessment of Nicotine Dependence among Smokers in a Selected Rural Population in Kerala, India
- Jayakrishnan, R. (Regional Cancer Centre) ;
- Mathew, Aleyamma (Regional Cancer Centre) ;
- Lekshmi, Kamala (Regional Cancer Centre) ;
- Sebastian, Paul (Regional Cancer Centre) ;
- Finne, Patrik (Tampere School of Public Health) ;
- Uutela, Antti (Department of Lifestyle and Participation, National Institute for Health and Welfare (THL))
- Published : 2012.06.30
Objectives: An attempt was made to understand the nicotine dependence of smokers selected for an ongoing smoking cessation intervention programme in rural Kerala, India. Methods: Data were collected from resident males in the age group of 18 to 60 years from 4 randomly allocated community development blocks of rural Thiruvananthapuram district (2 intervention and 2 control groups). Trained accredited social health activist workers were utilised to collect data from all groups through face to face interview. Nicotine dependence among participants was assessed by means of the six-item Fagerstrom Test for Nicotine Dependence (FTND) translated into the local language. The internal consistency of FTND was computed using Cronbach's alpha coefficient. Criterion validity (concurrent) was assessed by correlations of nicotine dependence scores with age at initiation of smoking and cumulative smoking volume in pack-years. Results: Among the 928 smokers identified, 474 subjects were in the intervention area (mean age = 44.6 years, SD = 9.66 years) and 454 in the control area (mean age = 44.5 years, SD = 10.30 years). The overall FTND score among current daily smokers was 5.04 (SD: 5.05). FTND scores in the control and intervention areas were 4.75 (SD: 2.57) and 4.92 (SD: 2.51) respectively. The FTND scores increased with age and decreased with higher literacy and socioeconomic status. The average FTND score was high among smokers using both bidi and cigarettes (mean 6.10, SD 2.17). Internal consistency analysis yielded a Cronbach's alpha coefficient of 0.70 in a subsample of 150 subjects, a moderate result. The association of the scale was strongest, with the number of pack-years smoked (rho = 0.677, p < 0.001). Conclusion: A moderate level of nicotine dependence was observed among smokers in the current study. Tobacco cessation strategies could be made more cost effective and productive if a baseline assessment of nicotine dependence is completed before any intervention.
Smoking;rural India;Fagerstrom test for nicotine dependence;tobacco cessation strategies
- Abdullah ASM, Husten CG (2004). Promotion of smoking cessation in developing countries: a framework for urgent public health interventions. Thorax, 59, 623-30. https://doi.org/10.1136/thx.2003.018820
- Banegal V (2005). Tobacco cessation-facilitators manual for busy clinicians. National institute of mental health and neuro sciences, Bangalore. In collaboration with World Health Organization & the Ministry of Health and Family Welfare, Government of India. p.10.
- Chandra PS, Carey MP, Carey KB, et al (2005). Prevalence and correlates of tobacco use and nicotine dependence among psychiatric patients in India. Addict Behav, 30, 1290-9. https://doi.org/10.1016/j.addbeh.2005.01.002
- Fagerstrom KO (1978). Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addic Behav, 3, 235-41. https://doi.org/10.1016/0306-4603(78)90024-2
- Heatherton TF, Kozlowski LT, Frecker RC, et al (1991). The Fagerstrom test for nicotine dependence: a revision of the Fagerstrom tolerance questionnaire. Br J Addict, 86, 1119-27. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x
- Hudmon KS, Pomerleau CS, Brigham J, et al (2005). Validity of retrospective assessments of nicotine dependence: a preliminary report. Addict Behav, 30, 613-7. https://doi.org/10.1016/j.addbeh.2004.08.006
- Jayakrishnan R, Mathew A, Uutela A, Finne P (2011). A community based smoking cessation intervention trial for rural Kerala, India - preliminary results. Asian Pac J Cancer Prev, 12, 3191-5.
- Jhanjee S, Sethi H (2010). The Fagerstrom Test for Nicotine Dependence in an Indian sample of daily smokers with poly drug use. Nicotine & Tobacco Res, 12, 1162-6. https://doi.org/10.1093/ntr/ntq148
- John U, Meyer C, Hapke U, et al (2003). The Fagerstrom test for nicotine dependence in two adult population samples—potential influence of lifetime amount of tobacco smoked on the degree of dependence. Drug Alcohol Depend, 71, 1-6. https://doi.org/10.1016/S0376-8716(03)00038-3
- Junqing WU, Tingzhong Y, Rockett IR, et al (2011). Nicotine dependence among rural-urban migrants in China. BMC Public Health, 11, 296. https://doi.org/10.1186/1471-2458-11-296
- Kaplan RM, Saccuzzo DP (2005). Psychological testing: principles, applications, and issues. Thomson/Wadsworth.
- Pakhele SS, Dolas SS, Maru GB (1997b). Determination of alkaloids, nitrate, nitrite, moisture and ph in tobacco varieties from different parts of India. Tob Res, 23, 11-8.
- Pakhele SS, Maru GB (1998). Distribution of major and minor alkaloids in tobacco, mainstream and side stream smoke of popular Indian smoking cigarettes. Food Chem Toxicol, 36, 1131-8. https://doi.org/10.1016/S0278-6915(98)00071-4
- Perez-Rios M, Santiago-Perez MI, Alonso B, et al (2009). Fagerstrom test for nicotine dependence vs. heavy smoking index in a general population survey. BMC Public Health, 9, 493. https://doi.org/10.1186/1471-2458-9-493
- Pomerleau CS, Carton SM, Lutzke ML, et al (1994). Reliability of the Fagerstrom tolerance questionnaire and the Fagerstrom test for nicotine dependence. Addict Behav, 19, 33-9. https://doi.org/10.1016/0306-4603(94)90049-3
- Reddy KS, Gupta PC (2004). Report on tobacco control in India. Ministry of Health and Family Welfare, 2004, Government of India, New Delhi. P.2
- Sahoo S, Raja Jayant KC (2010). Prevalence of tobacco use among young adult males in India: A community-based epidemiological study. Am J Drug & Alcohol Abuse, 36, 73-7. https://doi.org/10.3109/00952990903575814
- Sandip Kumar Ray (2005). National Rural Health Missionopportunity for Indian Public Health Association. Indian J Public Health, 49, 171-4.
- The Cigarettes and Other Tobacco Products Act, 2003 and related rules and regulations. Ministry of Health and Family Welfare, Government of India. P.3.
- Tobacco use. Global Adult Tobacco Survey: India Report 2009-2010 (2010), Ministry of Health and Family Welfare, Government of India. pp:1-36.
- Vink JM, Willemsen G, Beem A, et al (2005). The Fagerstrom test for nicotine dependence in a Dutch sample of daily smokers and ex-smokers. Addict Behav, 30, 575-9. https://doi.org/10.1016/j.addbeh.2004.05.023
- Weinberger AH, Reutenauer EL, Allen TM, et al (2007). Reliability of the fagerstrom test for nicotine dependence, minnesota nicotine withdrawal scale, and tiffany questionnaire for smoking urges in smokers with and without schizophrenia. Drug Alcohol Depend, 86, 278-82. https://doi.org/10.1016/j.drugalcdep.2006.06.005
- WHO Report on the Global Tobacco epidemic, 2008. The MPOWER package p: 8-9.
- Yang YK, McEvoy JP, Wilson WH, et al (2003). Reliabilities and intercorrelations of reported and objective measures of smoking in patients with schizophrenia. Schizophr Res, 60, 9-12.
- Extending Application of the 'Hardcore' Definition to Smokeless Tobacco Use: Estimates from a Nationally Representative Population in India and its Implications vol.13, pp.12, 2012, https://doi.org/10.7314/APJCP.2012.13.12.5959
- Smoking Cessation Intervention in Rural Kerala, India: Findings of a Randomised Controlled Trial vol.14, pp.11, 2013, https://doi.org/10.7314/APJCP.2013.14.11.6797
- Determinants of Tobacco Cessation Behaviour among Smokers and Smokeless Tobacco Users in the States of Gujarat and Andhra Pradesh, India vol.14, pp.3, 2013, https://doi.org/10.7314/APJCP.2013.14.3.1931
- Multiple Approaches and Participation Rate for a Community Based Smoking Cessation Intervention Trial in Rural Kerala, India vol.14, pp.5, 2013, https://doi.org/10.7314/APJCP.2013.14.5.2891
- Assessment of nicotine dependence among smokers in Nepal: a community based cross-sectional study vol.13, pp.1, 2015, https://doi.org/10.1186/s12971-015-0053-8
- Classification of nicotine-dependent users in India: a decision-tree approach pp.1613-2238, 2018, https://doi.org/10.1007/s10389-018-0973-x