David R Strong1, Karen Messer2, Sheri J Hartman2, Kevin P Conway3, Allison C Hoffman4, Nikolas Pharris-Ciurej4, Martha White2, Victoria R Green5, Wilson M Compton3, John Pierce2. 1. Cancer Prevention and Control Program, Moores UC San Diego Cancer Center, 3855 Health Sciences Drive #0901, La Jolla, CA 92093-0901, United States; Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive #0628, La Jolla, CA 92093-0638, United States. Electronic address: dstrong@ucsd.edu. 2. Cancer Prevention and Control Program, Moores UC San Diego Cancer Center, 3855 Health Sciences Drive #0901, La Jolla, CA 92093-0901, United States; Department of Family Medicine and Public Health, University of California, San Diego, 9500 Gilman Drive #0628, La Jolla, CA 92093-0638, United States. 3. National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, 6001 Executive Boulevard, Bethesda, MD 20892-9589, United States. 4. United States Food and Drug Administration, Center for Tobacco Products, 10903 New Hampshire Avenue, Silver Spring, MD 20993-0002, United States. 5. National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, 6001 Executive Boulevard, Bethesda, MD 20892-9589, United States; Kelly Government Solutions, 6101 Executive Boulevard, Bethesda, MD, 20852, United States.
Abstract
BACKGROUND: Nicotine dependence (ND) is a key construct that organizes physiological and behavioral symptoms associated with persistent nicotine intake. Measurement of ND has focused primarily on cigarette smokers. Thus, validation of brief instruments that apply to a broad spectrum of tobacco product users is needed. METHODS: We examined multiple domains of ND in a longitudinal national study of the United States population, the United States National Epidemiological Survey of Alcohol and Related Conditions (NESARC). We used methods based in item response theory to identify and validate increasingly brief measures of ND that included symptoms to assess ND similarly among cigarette, cigar, smokeless, and poly tobacco users. RESULTS: Confirmatory factor analytic models supported a single, primary dimension underlying symptoms of ND across tobacco use groups. Differential Item Functioning (DIF) analysis generated little support for systematic differences in response to symptoms of ND across tobacco use groups. We established significant concurrent and predictive validity of brief 3- and 5-symptom indices for measuring ND. CONCLUSIONS: Measuring ND across tobacco use groups with a common set of symptoms facilitates evaluation of tobacco use in an evolving marketplace of tobacco and nicotine products.
BACKGROUND:Nicotine dependence (ND) is a key construct that organizes physiological and behavioral symptoms associated with persistent nicotine intake. Measurement of ND has focused primarily on cigarette smokers. Thus, validation of brief instruments that apply to a broad spectrum of tobacco product users is needed. METHODS: We examined multiple domains of ND in a longitudinal national study of the United States population, the United States National Epidemiological Survey of Alcohol and Related Conditions (NESARC). We used methods based in item response theory to identify and validate increasingly brief measures of ND that included symptoms to assess ND similarly among cigarette, cigar, smokeless, and poly tobacco users. RESULTS: Confirmatory factor analytic models supported a single, primary dimension underlying symptoms of ND across tobacco use groups. Differential Item Functioning (DIF) analysis generated little support for systematic differences in response to symptoms of ND across tobacco use groups. We established significant concurrent and predictive validity of brief 3- and 5-symptom indices for measuring ND. CONCLUSIONS: Measuring ND across tobacco use groups with a common set of symptoms facilitates evaluation of tobacco use in an evolving marketplace of tobacco and nicotine products.
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