Paper
Friday, July 13, 2007
Adequacy of the Fagerstrom Test for Nicotine Dependence with Pregnant Adolescent Smokers
Betty J. Braxter, RN, PhD, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| Learning Objective #1: describe the level of nicotine dependence in African American and Caucasian pregnant adolescent smokers. |
| Learning Objective #2: discuss the adequacy of the Fagerstom Test for Nicotine Dependence to quantify nicotine dependence in two ethnic groups of pregnant adolescent smokers. |
Nicotine dependence is critical to the maintenance of smoking behaviors and failure to quit. One extant measure, the Fagerstrom Test for Nicotine Dependence (FTND)(Heatherton, Kozlowski, Frecker & Fagerstrom, 1991), has been widely used with adult populations. Information on the adequacy (e.g., reliability and validity) of the FTND as a measure of nicotine dependence with pregnant adolescent smokers is scant. Specific aims of this study were to: 1) assess the level of nicotine dependence among African American and Caucasian pregnant adolescent smokers using the FTND; and 2) examine the adequacy of the FTND to quantify nicotine dependence in both ethnic groups. Method. As a secondary analysis of baseline data drawn from four smoking cessation trials, the study employed a correlational descriptive design. The sample was comprised of 92 African American (mean age 16.6, S.D 1.3) and 91 Caucasian (mean age 17.0, S.D. 1.1) pregnant adolescent smokers recruited from pre-natal clinics in a mid-sized northeastern city. Participants completed three self-report measures with the 6-item FTND embedded in two of the measures. Analysis. Descriptive statistics, Cronbach alpha, Kendall Tau and Pearson correlations were employed. Results. The mean FTND total score was 3.2 (S.D. 1.5) for African American participants compared to 3.6 (S.D. 1.5) for their Caucasian counterparts. For both ethnic groups, the mean baseline total FTND score was indicative of low dependence. Alpha coefficients were respectively 0.26 for the African American participants versus 0.55 for the Caucasian participants. For African American participants, very modest correlations between FTND items and validity indicators were found compared to modest correlations reported for Caucasian participants. Conclusions. The findings suggest that the FTND did not meet minimum reliability standards for both of the ethnic groups. Validity of the scale with African American participants was not well supported. In contrast, the scale performed well with Caucasian participants.