PDF
ePub
Citation
Print
Abstract
Background
Smoking is one of the most important leading causes of morbidity and mortality. Smoking habit is recognized as nicotine dependence, which consists of physical and psychosocial dependence. To evaluate social nicotine dependence, the Kano Test for Social Nicotine Dependence (KTSND) working group developed a new questionnaire, which consists of 10 questions with a total score of 30 in Japan. We examined the social nicotine dependence among healthy adults using the new KTSND questionnaire and evaluated validity of the KTSND questionnaire in Korea.
Method
We applied Korean KTSND questionnaire version 2 to employees of hospital, university students and people for medical examination and promotion test. Complete data obtained from the 741 responders were analyzed.
Result
The mean age of responders was 31.8 years. Among them, males were 57.8%. Current smokers, ex-smokers, and non-smokers were 13.8%, 12.8%, and 73.4% respectively. According to smoking status, the total KTSND scores of current smokers were significantly higher than those of ex-smokers, and of non-smokers (17.1±5.4 versus 14.3±5.5, and 12.3±5.5, p≤0.001). The total KTSND scores of males were higher than those of females, suggesting that males have a propensity for depending nicotine socially much more than females (14.3±5.7 and 11.7±5.4 respectively, p<0.001). Eight of ten questions produced significantly different scores among three different smoking groups. When current smokers were sub-classified by heavy smoking index (HSI) that represented physical nicotine dependence, we did not find a significant difference of KTSND score between low HSI group (<4) and high HSI group (≥4), This finding suggested that the psychosocial dependence might play a different role from physical nicotine dependence in smoking. Most of the non-smokers (62.5%) had an experience of harmful passive smoking especially in public place.
Figures and Tables
Figure 1
The total KTSND scores among male and female. Data is presented as the mean±SD. Scales represent the total scores of the KTSND in all responders. Data is presented as the mean±SD (*p<0.001).
Figure 2
The total KTSND scores among smokers, ex-smokers and non-smokers. Scales represent the total scores of the KTSND. Data is presented as the mean±SD (*p<0.001, **p=0.001).
Figure 3
The total KTSND scores in smokers sub-classified by cigarettes smoked per day. Scales represent the total scores of the KTSND. Data is presented as the mean±SD. There is no significant difference among the four groups (p=0.901).
Figure 4
The total KTSND scores in smokers sub-classified by the time until the first cigarette of the day. Scales represent the total scores of the KTSND. Data is presented as the mean±SD. There is no significant difference among the four groups (p=0.915).
Figure 5
The total KTSND scores in smokers sub-classified by heavy smoking index with cut-off value 4. There is no significant difference between two groups (p=0.509).
References
1. Godtfredsen NS, Holst C, Prescott E, Vestbo J, Osler M. Smoking reduction, smoking cessation, and mortality: a 16-year follow-up of 19,732 men and women from The Copenhagen Centre for Prospective Population Studies. Am J Epidemiol. 2002. 156:994–1001.
2. Centers for Disease Control and Prevention (CDC). Annual smoking-attributable mortality, years of potential life lost, and economic costs-- United States, 1995-1999. MMWR Morb Mortal Wkly Rep. 2002. 51:300–303.
3. American Society of Clinical Oncology. Tobacco control: reducing cancer incidence and saving lives. J Clin Oncol. 1996. 14:1961–1963.
4. Unites States Surgeon General. The health consequence of smoking: chronic obstructive pulmonary disease. 1989. Washington DC: US department of Health and Human Service.
5. A clinical practice guideline for treating tobacco use and dependence: A US Public Health Service report. The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives. JAMA. 2000. 283:3244–3254.
6. Cancer Facts and Figures 2007. American Cancer Society. 2007. accessed on 2007 Feb 15. Atlanta: American Cancer Society;Available from: http://www.cancer.org/docroot/STT/content/STT_1x_Cancer_Facts__Figures_2007.asp.
7. The health consequence of smoking. A report of the Surgeon General. 2004. Atlanta, GA: US department of Health and Human Services. Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
8. Fries JF, Green LW, Levine S. Health promotion and the compression of morbidity. Lancet. 1989. 1:481–483.
9. LaCroix AZ, Lang J, Scherr P, Wallace RB, Cornoni-Huntley J, Berkman L, et al. Smoking and mortality among older men and women in three communities. N Engl J Med. 1991. 324:1619–1625.
10. Rigotti NA. Clinical practice. Treatment of tobacco use and dependence. N Engl J Med. 2002. 346:506–512.
11. Lasser K, Boyd JW, Woolhandler S, Himmelstein DU, McCormick D, Bor DH. Smoking and mental illness: a population-based prevalence study. JAMA. 2000. 284:2606–2610.
12. Fagerström KO. Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addict Behav. 1978. 3:235–241.
13. Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991. 86:1119–1127.
14. Etter JF, Duc TV, Perneger TV. Validity of the Fagerström test for nicotine dependence and of the Heaviness of Smoking Index among relatively light smokers. Addiction. 1999. 94:269–281.
15. Dijkstra A, Tromp D. Is the FTND a measure of physical as well as psychological tobacco dependence? J Subst Abuse Treat. 2002. 23:367–374.
16. Yoshii C, Kano M, Isomura T, Kunitomo F, Aizawa M, Harada H, et al. Innovative questionnaire examining psychological nicotine dependence, "The Kano Test for Social Nicotine Dependence (KTSND)". J UOEH. 2006. 28:45–55.
17. Heatherton TF, Kozlowski LT, Frecker RC, Rickert W, Robinson J. Measuring the heaviness of smoking: using self-reported time to the first cigarette of the day and number of cigarettes smoked per day. Br J Addict. 1989. 84:791–799.
18. Diaz FJ, Jane M, Salto E, Pardell H, Salleras L, Pinet C, et al. A brief measure of high nicotine dependence for busy clinicians and large epidemiological surveys. Aust N Z J Psychiatry. 2005. 39:161–168.
19. Tonnesen P, Carrozzi L, Fagerström KO, Gratziou C, Jimenez-Ruiz C, Nardini S, et al. Smoking cessation in patients with respiratory disease: a high priority, integral component of therapy. Eur Respir J. 2007. 29:390–417.
20. Dijkstra A, De Vries H, Kok G, Roijackers J. Self-evaluation and motivation to change: social cognitive constructs in smoking cessation. Psychol Health. 1999. 14:747–759.
21. John U, Meyer C, Hapke U, Rumpf HJ. Nicotine dependence and lifetime amount of smoking in a population sample. Eur J Public Health. 2004. 14:182–185.
22. Fiore MC, Smith SS, Jorenby DE, Baker TB. The effectiveness of the nicotine patch for smoking cessation. A meta-analysis. JAMA. 1994. 271:1940–1947.
23. Lerman C, Patterson F, Berrettini W. Treating tobacco dependence: state of the science and new directions. J Clin Oncol. 2005. 23:311–323.
24. Yudkin P, Hey K, Roberts S, Welch S, Murphy M, Walton R. Abstinence from smoking eight years after participation in randomised controlled trial of nicotine patch. BMJ. 2003. 327:28–29.
25. Wiggers LC, Oort FJ, Dijkstra A, de Haes JC, Legemate DA, Smets EM. Cognitive changes in cardiovascular patients following a tailored behavioral smoking cessation intervention. Prev Med. 2005. 40:812–821.
XML Download