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Protocol - Cigarette Nicotine Dependence

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Description:

Measurement of respondent’s symptoms of cigarette dependence.

Protocol:

The Working Group acknowledges that the following questions may gather sensitive information relating to the use of substances and/or illegal conduct. If the information is released it might be damaging to an individual’s employability, lead to social stigmatization, or other consequences. For information on obtaining a Certificate of Confidentiality, which helps researchers protect the privacy of human research participants, please go to the National Human Genome Research Institute’s Institutional Review Board website. The Working Group modified the questions to ask about current and past behaviors. The interviewer should change the introductory statement, depending on whether they are asking about current or past behaviors and choose the appropriate verb tense.

Current Every-Day or Current Some-Day Smokers: Instructions to interviewer: The following six questions are asked twice: once with the lead-in statement about current usage and, if appropriate, a second time with the lead-in statement about the period of maximum usage. a. Currently,... (ask 6 questions) b. Was there a 6-month period when you smoked more than you do now? (If "Yes," then continue to ask 6 questions again. If "No," stop.)

1. How soon after you wake up do/did you smoke your first cigarette?

[ ] 1 Within 5 minutes [3 points]

[ ] 2 6-30 minutes [2 points]

[ ] 3 31-60 minutes [1 point]

[ ] 4 After 60 minutes [0 points] 2. Do/Did you find it difficult to refrain from smoking in places where it is forbidden, e.g., in church, at the library, in a cinema, etc.?

[ ] 1 Yes [1 point]

[ ] 2 No [0 points]

3. Which cigarette would you hate most to give up?

[ ] 1 The first one in the morning [1 point]

[ ] 2 All others [0 points]

4. How many cigarettes per day do/did you smoke?

[ ] 1 10 or less [0 points]

[ ] 2 11-20 [1 point]

[ ] 3 21-30 [2 points]

[ ] 4 31 or more [3 points]

5. Do/did you smoke more frequently during the first hours after waking than during the rest of the day?

[ ] 1 Yes [1 point]

[ ] 2 No [0 points]

6. Do/did you smoke if you are so ill that you are in bed most of the day?

[ ] 1 Yes [1 point]

[ ] 2 No [0 points]

Former Smokers: Instructions to interviewer: The following 6 questions are asked about the period of maximum usage. Read the lead-in statement before asking the questions. Think about the six-month period when you were smoking the most... (ask 6 questions)

1. How soon after you wake up did you smoke your first cigarette?

[ ] 1 Within 5 minutes [3 points]

[ ] 2 6-30 minutes [2 points]

[ ] 3 31-60 minutes [1 point]

[ ] 4 after 60 minutes [0 points]

2. Did you find it difficult to refrain from smoking in places where it is forbidden, e.g., in church, at the library, in a cinema, etc.?

[ ] 1 Yes [1 point]

[ ] 2 No [0 points]

3. Which cigarette would you have hated most to give up?

[ ] 1 The first one in the morning [1 point]

[ ] 2 All others [0 points]

4. How many cigarettes per day did you smoke?

[ ] 1 10 or less [0 points]

[ ] 2 11-20 [1 point]

[ ] 3 21-30 [2 points]

[ ] 4 31 or more [3 points]

5. Did you smoke more frequently during the first hours after waking than during the rest of the day?

[ ] 1 Yes [1 point]

[ ] 2 No [0 points]

6. Did you smoke when you are so ill that you are in bed most of the day?

[ ] 1 Yes [1 point]

[ ] 2 No [0 points]

Note on how to score the results:

  • Sum the points for each round of 6 questions asked.
  • The highest score determines lifetime dependence. If the highest score is greater than 4, then the subject meets criteria for lifetime nicotine dependence.

If the score is 4 or more for current smokers who answered the first round of questions ("Currently..."), then the respondent also meets criteria for current dependence.

Protocol Name from Source:

Fagerstrom Test for Nicotine Dependence

Availability:

Publicly available

Personnel and Training Required

Interviewer must be trained and found competent to conduct personal interviews with individuals from the general population. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Interviewer-administered questionnaire

Life Stage:

Adult

Participants:

≥17 years old

Specific Instructions:

Respondents are asked the cigarette nicotine dependence questions only if they have been classified as a Current Every-Day Smoker, Current Some-Day Smoker, or Former Smoker based on responses to the adolescent and adult Tobacco - Smoking Status protocols. Respondents are asked six categorical questions to assess nicotine dependence. The six questions in this protocol may be asked twice for Current Every-Day and Current Some-Day Smokers: the first time using the current time frame and then a second time if there was a time period when the respondent smoked more than the current amount. During the second round of questions, the time frame is the 6-month period when the respondent was smoking the most. Former Smokers are asked the six questions once; the period of reference is the 6-month period when the respondent was smoking the most.

It should be noted that this measure is not intended to be used for other tobacco products and could be difficult to use with light smokes because cigarettes per day is a key variable.

Selection Rationale

The Fagerstrom Test for Nicotine Dependence has been validated and psychometrically tested and has been widely used in the nicotine research field.

Language

English, Available in other languages

Standards
StandardNameIDSource
Common Data Elements (CDE) Person Nicotine Dependence 2820895 CDE Browser
Logical Observation Identifiers Names and Codes (LOINC) Tobac nicotine depend proto 62503-8 LOINC
Process and Review

The Expert Review Panel #3 (ERP 3) reviewed the measures in Alcohol, Tobacco and Other Substances, and Substance Abuse and Addiction domains.

Guidance from ERP 3 includes:

• Changed Name of Measure and updated specific instructions to notify users of this measure’s exclusive use to cigarette smokers.

Back-compatible: Partially back-compatible (updated/similar protocol which would require some changes to the data dictionary), variable mapping between current and previous protocols can be found here.

Previous version in Toolkit archive (link)

Source

Permission to use this scale was obtained from K. O. Fagerstrom (personal communication, January 2009). Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The Fagerstrom Test for Nicotine Dependence: A revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction, 86, 1119-1127. Fagerstrom Test for Nicotine Dependence (questions 1-6).

General References

Bierut, L. J., Madden, P. A., Breslau, N., Johnson, E. O., Hatsukami, D., Pomerleau, O. F., Swan, G. E., Rutter, J., Bertelsen, S., Fox, L., Fugman, D., Goate, A. M., Hinrichs, A. L., Konvicka, K., Martin, N. G., Montgomery, G. W., Saccone, N. L., Saccone, S. F., Wang, J. C., Chase, G. A., Rice, J. P., & Ballinger, D. G. (2007). Novel genes identified in a high-density genome wide association study for nicotine dependence. Human Molecular Genetics, 16(1), 24-35.

Protocol ID:

31001

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX031001_Current_Smoker_1stSmoke_Givingup PX031001030000 Current Every-Day or Current Some-Day Smokers Which cigarette would you hate most to give up? 4 Variable Mapping
PX031001_Current_Smoker_1stSmoke_Time PX031001010000 Current Every-Day or Current Some-Day Smokers How soon after you wake up do/did you smoke your first cigarette? 4 Variable Mapping
PX031001_Current_Smoker_More PX031001070000 Was there a 6-month period when you smoked more than you do now? 4 N/A
PX031001_Current_Smoker_More_1stHour PX031001050000 Current Every-Day or Current Some-Day Smokers Do/did you smoke more frequently during the first hours after waking than during the rest of the day? 4 Variable Mapping
PX031001_Current_Smoker_More_1stSmoke_Givingup PX031001100000 Current Every-Day or Current Some-Day Smokers Which cigarette would you hate most to give up? 4 Variable Mapping
PX031001_Current_Smoker_More_1stSmoke_Time PX031001080000 Current Every-Day or Current Some-Day Smokers How soon after you wake up do/did you smoke your first cigarette? 4 Variable Mapping
PX031001_Current_Smoker_More_More_1stHour PX031001120000 Current Every-Day or Current Some-Day Smokers Do/did you smoke more frequently during the first hours after waking than during the rest of the day? 4 Variable Mapping
PX031001_Current_Smoker_More_Quantity_1Day PX031001110000 Current Every-Day or Current Some-Day Smokers How many cigarettes per day do/did you smoke? 4 Variable Mapping
PX031001_Current_Smoker_More_Refraining_Difficulty PX031001090000 Current Every-Day or Current Some-Day Smokers Do/Did you find it difficult to refrain from smoking in places where it is forbidden, e.g., in church, at the library, in a cinema, etc.? 4 Variable Mapping
PX031001_Current_Smoker_More_Smoking_During_Illness PX031001130000 Current Every-Day or Current Some-Day Smokers Do/did you smoke if you are so ill that you are in bed most of the day? 4 Variable Mapping
PX031001_Current_Smoker_Quantity_1Day PX031001040000 Current Every-Day or Current Some-Day Smokers How many cigarettes per day do/did you smoke? 4 Variable Mapping
PX031001_Current_Smoker_Refraining_Difficulty PX031001020000 Current Every-Day or Current Some-Day Smokers Do/Did you find it difficult to refrain from smoking in places where it is forbidden, e.g., in church, at the library, in a cinema, etc.? 4 Variable Mapping
PX031001_Current_Smoker_Smoking_During_Illness PX031001060000 Current Every-Day or Current Some-Day Smokers Do/did you smoke if you are so ill that you are in bed most of the day? 4 Variable Mapping
PX031001_Former_Smoker_1stSmoke_Givingup PX031001160000 Former Smokers Which cigarette would you hate most to give up? 4 Variable Mapping
PX031001_Former_Smoker_1stSmoke_Time PX031001140000 Former Smokers How soon after you wake up do/did you smoke your first cigarette? 4 Variable Mapping
PX031001_Former_Smoker_More_1stHour PX031001180000 Former Smokers Do/did you smoke more frequently during the first hours after waking than during the rest of the day? 4 Variable Mapping
PX031001_Former_Smoker_Quantity_1Day PX031001170000 Former Smokers How many cigarettes per day do/did you smoke? 4 Variable Mapping
PX031001_Former_Smoker_Refraining_Difficulty PX031001150000 Former Smokers Do/Did you find it difficult to refrain from smoking in places where it is forbidden, e.g., in church, at the library, in a cinema, etc.? 4 Variable Mapping
PX031001_Former_Smoker_Smoking_During_Illness PX031001190000 Former Smokers Do/did you smoke if you are so ill that you are in bed most of the day? 4 Variable Mapping
Research Domain Information
Measure Name:

Cigarette Nicotine Dependence

Release Date:

November 21, 2016

Definition

Questions query respondent on whether s/he has symptoms of nicotine dependence.

Purpose

This measure can be used to assess the participant’s dependence on nicotine.

Keywords

tobacco, smoking, cigarette, nicotine dependence, nicotine, pack years, Fagerstrom Test for Nicotine Dependence, Fagerstrom Tolerance Questionnaire, Fagerstrom