Nasir Mushtaq1, Rumana Huque2, Laura A Beebe3, Sarwat Shah4, Kamran Siddiqi4. 1. Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 4502 East 41st Street, SAC 1G06, Tulsa, OK 74135, United States. Electronic address: Nasir-Mushtaq@ouhsc.edu. 2. Department of Economics, University of Dhaka, Dhaka, 1000, Bangladesh. 3. Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States. 4. Department of Health Sciences, University of York, Heslington, York, YO10 5DD, United Kingdom.
Abstract
BACKGROUND: Despite the high prevalence of smokeless tobacco (ST) use in South Asia, ST dependence in this population has not been studied. Therefore, it is of interest to explore if ST dependence measures developed and validated in the western countries are of similar relevance to ST users who are culturally different and use distinct ST products. The aim of this study is to assess ST dependence among its users in Bangladesh by employing ST dependence scales based on three different approaches to measure tobacco dependence. METHODS: Data collected from a community-based sample of exclusive ST users living in Dhaka, Bangladesh (n = 200) were used for this study. Three ST dependence measures, Tobacco Dependence Screener (TDS), Fagerström Test for Nicotine Dependence for ST users (FTND-ST), and Oklahoma Scale for Smokeless Tobacco Dependence (OSSTD), were translated in Bangla and administered to the study participants. Saliva samples were collected for cotinine measurement. Reliability and concurrent and construct validity of FTND-ST and OSSTD were examined. RESULTS: Median cotinine concentration of the study participants was 440.2 (min = 2.9, max = 1874) ng/ml and 47% of them had TDS-based dependence diagnosis. Women had higher mean OSSTD, FTND-ST, and TDS scores as compared to men (p < 0.001). OSSTD demonstrated better reliability (α = 0.93) than FTND-ST, and TDS (α = 0.64 and 0.86, respectively). Concurrent validity of FTND-ST as evaluated by TDS, OSSTD, and cotinine concentration was affirmative. CONCLUSION: The FTND-ST is a valid and reliable tool to measure physical dependence among ST users in Bangladesh. The study was unable to replicate the structure of OSSTD.
BACKGROUND: Despite the high prevalence of smokeless tobacco (ST) use in South Asia, ST dependence in this population has not been studied. Therefore, it is of interest to explore if ST dependence measures developed and validated in the western countries are of similar relevance to ST users who are culturally different and use distinct ST products. The aim of this study is to assess ST dependence among its users in Bangladesh by employing ST dependence scales based on three different approaches to measure tobacco dependence. METHODS: Data collected from a community-based sample of exclusive ST users living in Dhaka, Bangladesh (n = 200) were used for this study. Three ST dependence measures, Tobacco Dependence Screener (TDS), Fagerström Test for Nicotine Dependence for ST users (FTND-ST), and Oklahoma Scale for Smokeless Tobacco Dependence (OSSTD), were translated in Bangla and administered to the study participants. Saliva samples were collected for cotinine measurement. Reliability and concurrent and construct validity of FTND-ST and OSSTD were examined. RESULTS: Median cotinine concentration of the study participants was 440.2 (min = 2.9, max = 1874) ng/ml and 47% of them had TDS-based dependence diagnosis. Women had higher mean OSSTD, FTND-ST, and TDS scores as compared to men (p < 0.001). OSSTD demonstrated better reliability (α = 0.93) than FTND-ST, and TDS (α = 0.64 and 0.86, respectively). Concurrent validity of FTND-ST as evaluated by TDS, OSSTD, and cotinine concentration was affirmative. CONCLUSION: The FTND-ST is a valid and reliable tool to measure physical dependence among ST users in Bangladesh. The study was unable to replicate the structure of OSSTD.
Keywords:
Fagerström test for nicotine dependence for ST users (FTND-ST); Oklahoma scale for smokeless tobacco dependence (OSSTD); Smokeless tobacco; Smokeless tobacco dependence scales; Smokeless tobacco in South Asia; Tobacco dependence
Authors: Shakil Ahmed; Fabeha Tazmeem; Mohammad Morshad Alam; Md Golam Kibria; Badrut Tamam Ahmed; Bappi Bhusan Das; Abdullah Al Amin; Ahmed Hossain Journal: Asian Pac J Cancer Prev Date: 2021-12-01