Association of tobacco dependence and quit attempt duration with Rasch-modeled withdrawal sensitivity using retrospective measures.
OBJECTIVE
To examine whether Rasch modeling would yield a unidimensional withdrawal sensitivity measure correlating with factors associated with successful smoking cessation.


METHODS
The psychometric Rasch modeling approach was applied to estimate an underlying latent construct (withdrawal sensitivity) in retrospective responses from 1644 smokers who reported quitting for 3 or more months at least once.


METHODS
Web-based, passcode-controlled self-administered computerized questionnaire.


METHODS
Randomly selected convenience sample of 1644 adult members of an e-mail invitation-only web panel drawn from consumer databases.


METHODS
Lifetime Tobacco Use Questionnaire, assessing tobacco use across the life-span, including demographics and respondent ratings of the severity of withdrawal symptoms experienced in respondents' first and most recent quit attempts lasting 3 or more months.


RESULTS
Rasch-modeled withdrawal sensitivity was generally unidimensional and was associated with longer periods of smoking cessation. One latent variable accounted for 74% of the variability in symptom scores. Rasch modeling with a single latent factor fitted withdrawal symptoms well, except for increased appetite, for which the fit was marginal. Demographic variables of education, gender and ethnicity were not related to changes in sensitivity. Correlates of greater withdrawal sensitivity in cessation attempts of at least 3 months included younger age at first quit attempt and indicators of tobacco dependence.


CONCLUSIONS
The relationship between tobacco dependence symptoms and Rasch-model withdrawal sensitivity defines further the relationship between sensitivity and dependence. The findings demonstrate the utility of modeling to create an individual-specific sensitivity measure as a tool for exploring the relationships among sensitivity, dependence and cessation.
Javitz
Harold S
HS
Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA. harold.javitz@sri.com
Brigham
Janet
J
Lessov-Schlaggar
Christina N
CN
Krasnow
Ruth E
RE
Swan
Gary E
GE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D012680:Sensitivity and Specificity; D016540:Smoking Cessation / Q000523:psychology*; D013315:Stress, Psychological; D013375:Substance Withdrawal Syndrome; D014029:Tobacco Use Disorder / Q000523:psychology*; D055815:Young Adult