Nicotine dependence versus smoking prevalence: comparisons among countries and categories of smokers.
OBJECTIVE
To collect available international data on nicotine dependence as defined by the Fagerström Test of Nicotine Dependence, and to compare levels of dependence among countries and categories of smokers.


METHODS
Published and unpublished studies known to the authors and a search of EMBASE from 1985-1995.


METHODS
Studies included were those based on a nationally representative sample of a country's population, or a sample of smokers seeking cessation assistance.


RESULTS
Smokers who seek help in stopping smoking are much more dependent than the average smoker. Men consistently score higher on dependence than women. Ex-smokers appear to have lower dependence than current smokers. A country with low smoking prevalence, the United States, seems to have smokers with higher dependence scores than countries where smoking is more prevalent (such as Austria and Poland).


CONCLUSIONS
Successful tobacco control may result in a higher dependence among the remaining smokers (due to selective quitting by low-dependent smokers). The remaining highly dependent smokers may need more intensive treatment.
Fagerström
K O
KO
Pharmacia Consumer Pharma, Research Laboratories, Helsingborg, Sweden.
Kunze
M
M
Schoberberger
R
R
Breslau
N
N
Hughes
J R
JR
Hurt
R D
RD
Puska
P
P
Ramström
L
L
Zatoński
W
W
D003469:Culture; D005260:Female; D014943:Global Health; D006801:Humans; D015994:Incidence; D008297:Male; D009538:Nicotine; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology*; D014029:Tobacco Use Disorder / Q000453:epidemiology*
D009538:Nicotine