Measuring adults' loss of autonomy over nicotine use: The Hooked on Nicotine Checklist

Abstract

The Hooked on Nicotine Checklist (HONC) is a 10-item screening tool originally developed to assess loss of autonomy over tobacco in adolescent smokers. A smoker's endorsement of any item indicates some loss of autonomy, and the sum of endorsed items indicates the degree to which autonomy has been lost. This study extends the HONC to adult smokers. Self-administered questionnaires were completed by a convenience sample of 1,102 adults who were recruited in their natural environments while observed smoking. Subjects were mostly experienced smokers who consumed a mean of 17.5 cigarettes per day and had smoked an average of 20.9 years. HONC scores ranged from 0 to 10, with a mean of 7.1. The HONC appears to measure a single dimension. Internal HONC consistency was high (alpha = .83), and interitem correlations were low to moderate. HONC scores correlated positively with levels of current and peak lifetime cigarette consumption. The HONC scores of heavy, moderate, and light smokers differed significantly in the expected direction. Subjects with higher HONC scores were more likely to report a shorter duration of abstinence and greater use of pharmacological aids when quitting. The HONC appears to be psychometrically sound in both adolescents and adults. It is a reliable and valid measure of lost autonomy for both novice and experienced smokers, and it allows for comparisons between these populations.

Light and intermittent cigarette smokers: a review (1989–2009)

“…Although they reported each of the symptoms measured by the "Hooked on Nicotine Checklist" (HONC) (Wellman et al 2005(Wellman et al , 2006a, chippers' level of autonomy was generally higher than that of daily smokers in a separate study (Wellman et al 2005), and their symptom intensity was low.…”

Smokers’ Understandings of Addiction to Nicotine and Tobacco: A Systematic Review and Interpretive Synthesis of Quantitative and Qualitative Research

“…[2][3][4] Various measures of nicotine dependence have been developed, validated and are in regular use in both research and clinical applications. [5][6][7][8] The constellation of features included in such measures include continued smoking despite known harms, difficulty quitting, feelings of craving or compulsion, and how long after waking someone smokes their first…”

A modified two-factor multivariate analysis of variance: asymptotics and small sample approximations

“…The level of depression for each subject was determined as low or high based on the Center for Epidemiologic Studies Depression Scale (Kohout et al 1993). Three well known scales of nicotine dependence are the Fagerström Test for Nicotine Dependence (Heatherton et al 1991), Hooked on Nicotine Checklist (Wellman et al 2005) and Minnesota Tobacco Withdrawal Scale (Hatsukami et al 1984). In the analysis that follows, we shorthand these variables as FTSD, HOOKNCTN and WDRSYPTM, respectively.…”