Abstract
A valid measure of dependence on cigarettes is a useful tool for clinicians and researchers. The aim of this study was to develop a new, self-administered measure of cigarette dependence, and to assess its validity. The content of the instrument was generated in qualitative surveys. A long version (114 items) was tested on the internet in 3009 smokers. Subsamples provided retest data after 18 days (n=578), follow-up data after 45 days (n=990) and saliva cotinine (n=105). The study resulted in a 12-item scale labelled the Cigarette Dependence Scale (CDS-12), and in a 5-item version of this scale (CDS-5). Except for tolerance, CDS-12 covers the main components of DSM-IV and ICD-10 definitions of dependence: compulsion, withdrawal symptoms, loss of control, time allocation, neglect of other activities, and persistence despite harm. CDS-5 has similar measurement properties but less comprehensive content. Both scales had a high test–retest reliability (r⩾0.83), and a high internal consistency (Cronbach's α⩾0.84). CDS-12 scores were higher in daily smokers than in occasional smokers (+1.3SD units), and were associated with the strength of the urge to smoke during the last quit attempt (R2⩾0.25), and with saliva cotinine (R2⩾0.17). CDS-12 and CDS-5 scores decreased in daily smokers who switched to occasional smoking at 18-day retest. Dependence scores did not predict smoking abstinence at follow-up. In conclusion, CDS-12 and CDS-5 are reliable measures of cigarette dependence which fulfill several criteria of content validity and construct validity and are sensitive to change over time.
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Acknowledgements
This study was supported by grants from the Swiss National Science Foundation to J-F Etter (3233-054994.98 and 3200-055141.98). Vincent Baujard, from the HON Foundation (www.hon.ch), developed the software for data collection.
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JFE was reimbursed by Pharmacia Inc., a producer of nicotine replacement products, for attending international conferences, and was paid by Novartis to give lectures on smoking cessation. The Institute of Social and Preventive Medicine at the University of Geneva received financial support from Novartis to develop an education program for users of nicotine replacement products. JLH works with Pharmacia In.
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Etter, JF., Le Houezec, J. & Perneger, T. A Self-Administered Questionnaire to Measure Dependence on Cigarettes: The Cigarette Dependence Scale. Neuropsychopharmacol 28, 359–370 (2003). https://doi.org/10.1038/sj.npp.1300030
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DOI: https://doi.org/10.1038/sj.npp.1300030
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