A Comparison of the Fagerström Test for Cigarette Dependence and Cigarette Dependence Scale in a Treatment-Seeking Sample of Pregnant Smokers

Abstract

Known previously as the Fagerström Tolerance Questionnaire 2 and Fagerström Test for Nicotine Dependence 3,4 the six-item FTCD is the most widely-used, brief measure of cigarette dependence. 5 The five-item Cigarette Dependence Scale 6 is also a brief and valid measure of cigarette dependence. The CDS-5 has psychometric properties similar to its parent measure, the CDS-12, but with less comprehensive content in terms of tapping compulsion, withdrawal symptoms, loss of control, time allocation, neglect of other activities, and persistence in smoking despite harm.Results of direct comparisons between the FTCD and the CDS have been mixed, with the vast majority of studies involving contrasts between the FTCD and CDS-12. In general, the FTCD and CDS-12 are moderately associated with each other and both are correlated positively with cigarettes per day and age at first daily smoking, 6-8 yet neither measure is associated significantly with the Methods:This was a secondary analysis of data of pregnant smokers (N = 476) enrolled in a smoking cessation study. We assessed internal consistency, reliability, and examined correlations between the instruments and smoking-related behaviors for construct validity. We evaluated predictive validity by testing how well the measures predict abstinence 2 weeks after quit date. Results: Cronbach's alpha coefficient for the CDS-5 was 0.62 and for the FTCD 0.55. Measures were strongly correlated with each other, although FTCD, but not CDS-5, was associated with saliva cotinine concentration. The FTCD, CDS-5, craving to smoke, and withdrawal symptoms failed to predict smoking status 2 weeks following the quit date. Conclusions: Suboptimal reliability estimates and failure to predict short-term smoking call into question the value of including either of the brief measures in studies that aim to explain the obstacles to smoking cessation during pregnancy.

Functional network connectivity predicts treatment outcome during treatment of nicotine use disorder

“…More robust outcome predictors are needed as, so far, few self-report measures have proven to be reliable. For example, even self-reported nicotine dependence severity shows inconsistent predictive value (Berlin et al, 2016; McPherson et al, 2014), and recent work in the same subject sample examined in the present manuscript found that a variety of predictors previously identified (mood, impulsiveness, age) were not predictive of treatment outcome (Wilcox et al, 2017). …”

Predictors of smoking cessation during pregnancy: a systematic review and meta‐analysis

“…Of the 40 observational studies, 19 were cross‐sectional and 21 were cohort studies . Fifteen studies used secondary data from RCTs .…”

“…All the studies recruited participants who were at least 16 years of age and the mean age of the women ranged from 16 to 50 years. Of the 17 studies (31.5%) that reported quit attempts, all or most of the participants made a quit attempt in 15 studies , while two other studies reported quit attempts for only 17% and 30% of the participants.…”

“…Sixteen studies, three observational and 13 RCTs , reported predictors of biochemically validated smoking abstinence in pregnancy, using salivary or urine cotinine and/or expired carbon monoxide (CO) or urine thiocyanate assays. Three of the observational studies and two of the RCTs reported predictors of spontaneous quitting during pregnancy without biochemical validation.…”

Which measures of cigarette dependence are predictors of smoking cessation during pregnancy? Analysis of data from a randomized controlled trial

“…For example, among pregnant smokers the odds of cessation have been related inversely to baseline cotinine level 24, and in another study 29 scores for Fagerström Test of Cigarette Dependence (FTCD), urges to smoke and withdrawal symptoms failed to predict smoking status 2 weeks following the quit date. Therefore, in this study we examined the predictive validity of common measures of dependence on smoking cessation in pregnancy.…”