Is it about substituting an addiction with another? Development and initial psychometric properties of the first Heated Tobacco Products Addiction Questionnaire (HeaTPAQ)

Abstract

Background: Public health experts currently agree that heated tobacco products (HTPs) pose a significant health risk for their consumers. The same concentrations and speed of delivery of nicotine found for HTPs and conventional combustion cigarettes make it necessary to consider the addictiveness of HTPs, and provide precise diagnostic instruments to serve as the basis for effective treatment plans. Therefore, the main objectives of this study were to design a questionnaire for HTPs addiction called “Heated Tobacco Products Addiction Questionnaire (HeaTPAQ)” and to examine its psychometric properties. Methods: Adults from the general population of Lebanon (n = 754) were administered the HeatPAQ, along with the Fagerström test for nicotine dependence (FTND), the Generalized Anxiety Disorder 7-item, and the Patient Health Questionnaire-9. We split the main sample into two subsamples; subsample 1 consisting of 33% of the participants used for the exploratory factor analysis (EFA) (n=246; mean age 27.82±9.38 years) and subsample 2 consisting of 67% of the participants used for the confirmatory factor analysis (CFA) (n=508; mean age 27.81±8.80 years). Results: EFA then CFA analyses revealed a one-factor model consisting of 13 items with acceptable fit to the data. The HeaTPAQ reached excellent internal consistency coefficients, with both Cronbach’s α and McDonald’s ω values of .96. The one-dimensional structure of the HeaTPAQ was found to be invariant across sex groups. Convergent validity was demonstrated through significant positive correlation with FTND scores. Furthermore, HeaTPAQ scores correlated positively with measures of anxiety and depression, which suggests the adequate concurrent validity of the scale. Conclusion: Findings suggest that the HeatPAQ is a specific, short and simple-to-use self-report questionnaire to assess HTPs addiction reliably and validly. We hope that the HeatPAQ will facilitate routine screening for HTPs addiction, which is an essential step towards appropriate prevention and intervention efforts and to inform policy makers.