Elsevier

Addictive Behaviors

Volume 25, Issue 3, May–June 2000, Pages 429-433
Addictive Behaviors

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Validation of the modified fagerström tolerance questionnaire with salivary cotinine among adolescents

https://doi.org/10.1016/S0306-4603(98)00132-4Get rights and content

Abstract

This study was conducted to gain evidence of validity for a nicotine dependence measure for adolescent smokers. We hypothesized that the individual item responses and the total Fagerström Tolerance Questionnaire (FTQ) score would be positively correlated with cotinine values. We examined the relationship between a seven-item modified FTQ and saliva continine among 131 adolescent volunteers in a smoking cessation program. As anticipated, the total FTQ score was related to saliva cotinine (r = .40, p < .01), as were six of the seven individual FTQ items (p < .05). Our findings provide preliminary evidence that the modified FTQ scale is valid and applicable to adolescent smokers.

Section snippets

Subjects

This investigation uses data from volunteer students in a smoking prevention and cessation program administered at four vocational-technical schools in Rhode Island. The sample for this analysis included 131 students who currently were smoking one or more cigarettes per week; 49% were male, 93% were White, and the mean age was 17.7 years (SD = 0.8). On average, subjects had smoked regularly for 3.1 years (SD = 1.7).

Survey administration and biochemical validation

A modified version of the FTQ scale was incorporated into the project's

Results

The mean FTQ scale score was 3.74 (SD = 1.70). The interitem correlations ranged from −.04 to .52. The item “Do you inhale?” exhibited either negative or modestly positive associations with other scale items. Item-to-total score correlations ranged from .08 to .59. The Cronbach alpha estimate of internal consistency for the seven items was .70; omission of the inhalation item would have increased the alpha minimally to .71.

As hypothesized, we observed a significant positive correlation between

Discussion

With a half-life exceeding that of nicotine, cotinine is considered to be the “gold standard” for measuring nicotine intake Etzel 1990, Fagerström & Schneider 1989. For this reason, it was selected as the reference measure in our study. Saliva sampling for cotinine analysis is a routine procedure in adolescent smoking studies and has been shown to provide comparable information on nicotine levels as plasma cotinine (Curvall, Elwin, Kazemi-Vala, Warholm, & Enzell, 1990).

Overall, the scale

Acknowledgements

The cotinine assays were performed by Dr. Douglas Hoffman, Neurochemistry Laboratory, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756. The study was approved by the University of Rhode Island Institutional Review Board.

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This study was supported by two grants from the American Cancer Society: ACS PRB-70 and ACS PRB-70-A. Cotinine analyses were made possible by a grant provided by SmithKline-Beecham Healthcare.

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