Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Heaviness of Smoking Index, Number of Cigarettes Smoked and the Fagerstrom Test for Nicotine Dependence Among Adult Male Malaysians

  • Lim, K.H. (Institute for Public Health) ;
  • Idzwan, M. Feisul (Non Communicable Disease Section, Disease Control Division, Ministry of Health) ;
  • Sumarni, M.G. (Institute for Medical Research) ;
  • Kee, C.C. (Institute for Medical Research) ;
  • Amal, N.M. (Institute for Medical Research) ;
  • Lim, K.K. (Institute for Public Health) ;
  • Gurpreet, K. (Institute for Public Health)
  • Published : 2012.01.31
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Abstract

Two methods of identifying smokers with high nicotine dependence, the heaviness of smoking index (HSI) and number of cigarettes per day (CPD) were compared with the Fagerstrom test for nicotine dependence (FTND). The HSI, CPD and the FTND were administered to 316 adult Malaysian male, daily smokers aged between 25-64 years old in the Malaysian NCD Surveillance-1 Survey using a two-stage stratified random sampling of enumeration blocks and living quarters, via an interview based on a validated questionnaire. The cut-off point for classification of high nicotine dependence on the HSI was a score of four or higher, and for the heavy smoking category, smoking more than 20 cigarettes per day. Classification using each method was compared with classification by the FTND (score of six or more) as the reference standard. Sensitivity, specificity and kappa statistics for concordance between both measures and the FTND were evaluated. The HSI gave a similar prevalence rate of high nicotine dependence as the FTND. There was substantial agreement between the HSI and the FTND (kappa=0.63.), with moderate sensitivity (69.8%) and high specificity (92.5%). However, prevalence of high nicotine dependence using the CPD was 7% lower than the FTND. The heavy smoking category also showed fair agreement with the FTND (kappa=0.45) and moderate sensitivity (67.0%), but specificity was high (86.9%). The findings indicate that the HSI can be used as an alternative to the FTND in screening for high nicotine dependence among daily smokers in large population-based studies, while CPD may not be a suitable alternative to the FTND.

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References

  1. Benowitz NL, Peyton J, Ahijevych K, et al (2002). Biochemical verification of tobacco use and cessation. Nicotine Tob Res, 4, 149-59. https://doi.org/10.1080/14622200210123581
  2. Breslau N, Johnson EO, Hiripi E, et al (2001). Nicotine dependence in the United States: Prevalence, trends and smoking persistence. Arch Gen Psychiat, 58, 810-6. https://doi.org/10.1001/archpsyc.58.9.810
  3. Chabrol H, Niezborala M, Chastan E, et al (2005). Comparison of the Heavy Smoking Index and of the Fagerström Test for Nicotine Dependence in a sample of 749 cigarette smokers. Addict Behav, 30, 1474-7. https://doi.org/10.1016/j.addbeh.2005.02.001
  4. de Leon J, Diaz FJ, Becona E, et al (2003). Exploring brief measures of nicotine dependence for epidemiological surveys. Addict Behav, 28, 1481-6. https://doi.org/10.1016/S0306-4603(02)00264-2
  5. Diaz FJ, Jane M, Salto E, et al (2005). A brief measure of high nicotine dependence for busy clinicians and large epidemiological surveys. Aust N Z J Psychiatry, 39,161-8. https://doi.org/10.1080/j.1440-1614.2005.01538.x
  6. Etter JF (2005). A comparison of the content, construct and predictive validity of the cigarette dependence scale and the Fagerstrom test for nicotine dependence. Drug Alcohol Depen, 77, 259-68. https://doi.org/10.1016/j.drugalcdep.2004.08.015
  7. Heatherton TF, Kozlowski LT, Frecker RC, et al (1991). The Fagerström test for nicotine dependence: A revision of the Fagerström Tolerance Questionnaire. Brit J Addict, 86, 1119-27. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x
  8. Institute for Public Health (2008). Smoking. The Third National Health and Morbidity Survey, 2006. Kuala Lumpur: Ministry of Health Malaysia.
  9. John U, Meyer C, Schumann A, et al (2004). A short form of the Fagerström Test for Nicotine Dependence and the Heaviness of Smoking Index in two adult population samples. Addict Behav, 29, 1207-12. https://doi.org/10.1016/j.addbeh.2004.03.019
  10. Klesges RC, Debon M, Ray JW(1995). Are self reported of smoking rate biased? Evidence from the Second National Health and Nutrition Examination Survey. J Clin Epidemiol, 48, 1225-33. https://doi.org/10.1016/0895-4356(95)00020-5
  11. Landis JR, Koch GG(1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159-74. https://doi.org/10.2307/2529310
  12. Noncommunicable Disease Section, Disease Control Division, (2006) MYNCDIS-1 Malaysia NCD Surveillanve-1 2005/2006, NCD Risk Factors in Malaysia,.Kuala Lumpur, Ministry of Health Malaysia
  13. Perez-Ríos 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
  14. Shiffman S, Waters A, Hickcox M (2004). The nicotine dependence syndrome scale: a multidimensional measure of nicotine dependence. Nicotine TobRes, 6, 327-48. https://doi.org/10.1080/1462220042000202481
  15. SPSS Inc (2007). SPSS for Windows, Release 16.0.1. Chicago, Illinois, SPSS Inc.

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