The Fagerstrom Test For Nicotine Dependence in An Indian Sample of Daily smokers With Poly Drug Use

Abstract

The Fagerström Test for Nicotine Dependence (FTND) is a widely used six-item questionnaire, which has often been used as a measure of physical dependence on nicotine. The performance of the FTND was explored in an Indian sample of 75 daily smokers with histories of polysubstance use attending the Tobacco Cessation Clinic at National Drug Dependence Treatment Centre. FTND score was found to be significantly correlated with the age of initiation but showed no correlation with duration of use. FTND had low reliability (Cronbach's alpha: .57) in the Indian setting. An exploratory factor analysis suggested that the FTND comprised 2 factors. Factor 1 was defined by questions regarding "time-to-first cigarette after waking," "difficulty refraining from smoking in forbidden places," and "amount smoked," which reflects the persistence to maintain the nicotine levels during waking hours, whereas Factor 2 was defined by questions regarding "which cigarette is most preferred" and "prominence of morning smoking and "smoking while ill," which explains the degree of urgency to restore nicotine levels to a given threshold after nighttime abstinence. A good amount of variance (56.34%) was explained by these factors. Cronbach's alpha, for each of the 2 domains was found to be .66 and .58, respectively. FTND was found to have low internal consistency reliability in this study. The study confirms a 2-factor structure of the FTND in a sample of polysubstance users. Thus, the FTND may assess 2 separate dimensions of nicotine addiction.