The Fagerström test for nicotine dependence in an Indian sample of daily smokers with poly drug use.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Jhanjee
Sonali
S
National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Sethi
Hem
H
D000328:Adult; D019973:Alcohol-Related Disorders / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology; D006801:Humans; D007194:India; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires / Q000592:standards*; D014029:Tobacco Use Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult