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Protocol - Cigarette Nicotine Dependence

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Description

Measurement of respondent’s symptoms of cigarette dependence.

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 smokers because cigarettes per day is a key variable.

Availability

Available

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.

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

Lifestage

Adult

Participants

≥17 years old

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

Chinese, English, Other languages available at source

Standards
StandardNameIDSource
Logical Observation Identifiers Names and Codes (LOINC) Tobac nicotine depend proto 62503-8 LOINC
caDSR Form PhenX PX031001 - Tobacco Nicotine Dependence 5828404 caDSR Form
Derived Variables

Pack-years: (Tobacco - 30-Day Quantity and Frequency)1 X (Duration)2 The estimation of the components of this calculation can be derived from several PhenX measures. 1 Tobacco - 30-Day Quantity and Frequency:

  • Adolescents: Response to question "On the [number of days reported in 2a or 2b] you smoked cigarettes during the past 30 days, how many cigarettes did you smoke per day, on average?"
  • Adults
    • Every-day smokers: Response to question "On the average, about how many cigarettes do you now smoke each day?"
    • Some-day smokers: [(Response to question "On the average, on those days, how many cigarettes did you usually smoke each day?") X (Response to "On how many of the past 30 days did you smoke cigarettes?")] / 30
    • Former smokers:
      • Respondents who smoked every day for ≥6 months: Response to question "When you last smoked every day, on average how many cigarettes did you smoke each day?"
      • Respondents who did not smoke every day for ≥6 months: Response to question "When you last smoked fairly regularly, on average how many cigarettes did you smoke each day?"
    • The Fagerstrom Test for Nicotine Dependence measure (4. How many cigarettes/day do you smoke?) can also be used to calculate the amount of cigarettes smoked.
      • Use the midpoint from the response category to obtain the number of cigarettes smoked per day.

2 Duration of smoking: (Tobacco - Age of Offset of Cigarette Use3 OR Current age) - (Tobacco - Age of Initiation of First Cigarette Use)4 3 Tobacco - Age of Offset of Cigarette Use:

  • Adolescents: (Current Age) - (length of time response to the question: "How old were you the last time you smoked part or all of a cigarette?")
  • Adults: (Current Age) - (length of time response to the question: "About how long has it been since you COMPLETELY quit smoking cigarettes?")

4 Tobacco - Age of Initiation of First Cigarette Use:

  • Adolescents: Age derived from the answer to: 2. "How old were you when you first started smoking cigarettes every day?" OR - For those who never smoked every day, the answer from 1. "How old were you when you first smoked part or all of a cigarette?"

Adults: Age derived from the answer to: 1. "How old were you when you first started smoking cigarettes every day?" OR - For those who never smoked every day, the answer from 2. "How old were you when you first started smoking cigarettes fairly regularly?"

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)

Protocol Name from Source

Fagerstrom Test for Nicotine Dependence, 1991

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

Cigarette Nicotine Dependence

Release Date

February 6, 2009

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, gerontology, aging, geriatrics

Measure Protocols
Protocol ID Protocol Name
31001 Cigarette Nicotine Dependence
Publications

Riley, E. D., et al. (2022) Ongoing tobacco use in women who experience homelessness and unstable housing: A prospective study to inform tobacco cessation interventions and policies. Addictive Behaviors. 2022 February; 125: 107125. doi: 10.1016/j.addbeh.2021.107125

Quach, B. C., et al. (2020) Expanding the genetic architecture of nicotine dependence and its shared genetics with multiple traits. Nature Communications. 2020 November; 11(1): Article Number: 5562. doi: 10.1038/s41467-020-19265-z

Lisdahl, K. M., et al. (2018) Adolescent brain cognitive development (ABCD) study: Overview of substance use assessment methods. Dev Cogn Neurosci. 2018 August; 32: 80-96. doi: 10.1016/j.dcn.2018.02.007

Krebs, N. M., et al. (2016) Comparison of Puff Volume With Cigarettes per Day in Predicting Nicotine Uptake Among Daily Smokers. Am J Epidemiol. 2016 July; 184(1): 48-57. doi: 10.1093/aje/kwv341