Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-23T11:16:16.188Z Has data issue: false hasContentIssue false

Spanish Adaptation of the NDSS (Nicotine Dependence Syndrome Scale) and Assessment of Nicotine-Dependent Individuals at Primary Care Health Centers in Spain

Published online by Cambridge University Press:  10 January 2013

Elisardo Becoña*
Affiliation:
Universidad de Santiago de Compostela (Spain)
Ana López
Affiliation:
Universidad de Santiago de Compostela (Spain)
Elena Fernández del Río
Affiliation:
Universidad de Santiago de Compostela (Spain)
Mª Carmen Míguez
Affiliation:
Universidad de Santiago de Compostela (Spain)
Josefina Castro
Affiliation:
Servicio Andaluz de Salud (Spain)
*
Correspondence concerning this article should be addressed to Elisardo Becoña. Unidad de Tabaquismo. Universidad de Santiago de Compostela. Facultad de Psicología. Departamento de Psicología Clínica y Psicobiología. Campus sur. 15782 Santiago de Compostela. (Spain). E-mail: [email protected].

Abstract

The availability of adequate instruments for the assessment of nicotine dependence is an important factor that is relevant in the area of tobacco addiction. In this study, we present a Spanish validation of the Nicotine Dependence Syndrome Scale (NDSS) (Shiffman, Waters, & Hickcox, 2004). The sample was composed of patients, all daily smokers, who visited their General Practitioner (GP) at five Primary Health Care Centers in different cities of Spain (N = 637). The results indicated adequate reliability for the general factor that assesses nicotine dependence (NDSS-Total) (Cronbach's α = .76). Factor analysis confirms the five factors of the original validation: Drive, Continuity, Stereotypy, Priority, and Tolerance. It must be noted that reliability is adequate for the first, and moderate or low for the rest. The NDSS-T and its scales correlate significantly with the Fagerström Test for Nicotine Dependence (FTND), with the nicotine dependence criteria of the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) as assessed through the Structured Clinical Interview for DSM-IV (SCID), with carbon monoxide levels in expired air (CO), and with the number of cigarettes smoked. The ROC curve indicates that the NDSS-T has a score of .79 which is under the curve (.69 for the FTND), thus the prediction of nicotine dependence is adequate. We conclude that this instrument is useful (in terms of its total score NDSS-T) for assessing nicotine dependence for Spanish smokers (in Spain), as has been found in other countries, language groups, and cultures.

Disponer de adecuados instrumentos de evaluación de la dependencia de la nicotina es un aspecto relevante en el área de la adicción al tabaco. En este estudio se presenta la validación española de la Escala del Síndrome de la Dependencia de la Nicotina (NDSS, Shiffman, Waters y Hickcox, 2004). La muestra estuvo formada por fumadores diarios de cigarrillos que acudieron a su médico de Atención Primaria en cinco centros de salud de diferentes ciudades de España (N = 637). Los resultados indican una adecuada fiabilidad para el factor general que evalúa dependencia de la nicotina (NDSS-Total) (α de Cronbach = .76). El análisis factorial confirma los cinco factores obtenidos en la validación original de la escala: Impulso, Continuidad, Estereotipia, Prioridad y Tolerancia. La fiabilidad es adecuada para el primer factor, y moderada o baja para el resto de los factores. La NDSS-T y sus escalas correlacionan significativamente con el Test de Dependencia de la Nicotina de Fagerström (FTND), con los criterios de dependencia de la nicotina del Manual Diagnóstico y Estadístico de los Trastornos Mentales-IV (DSM-IV), evaluados mediante la Entrevista Clínica Estructurada para el DSM-IV (SCID-IV), con el nivel de monóxido de carbono en aire espirado (CO), y con el número de cigarrillos fumados al día. La curva ROC indica que la NDSS-T tiene una puntuación de .79 bajo la curva (.69 para el FTND), lo que indica que la predicción de la dependencia de la nicotina es adecuada. Se concluye que este instrumento es útil (en relación a la puntuación total NDSS-T) para evaluar la dependencia de la nicotina en fumadores españoles (en España), tal y como se ha encontrado en otros países, lenguas y culturas.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2000). Diagnostic and statistical manual for mental disorders, 4th ed., revised text. Washington, D.C.: American Psychiatric Association.Google Scholar
Becoña, E., & Lorenzo, M. C. (2004). Evaluación de la conducta de fumar [Smoking behavior assessment]. Adicciones, 16 (Suppl. 2), 201226.Google Scholar
Becoña, E., & Vázquez, F. (1998). The Fagerström Test for Nicotine Dependence in a Spanish sample. Psychological Reports, 83, 1455.1458.Google Scholar
Brandon, T. H., Herzog, T. A., Chad, J. E., & Gwaltney, C. J. (2004). Cognitive and social learning models of drug dependence: Implications for the assessment of tobacco dependence in adolescents. Addiction, 99 (Suppl. 1), 5177.CrossRefGoogle ScholarPubMed
Breslau, N., Johnson, E. O., Hiripi, E., & Kessler, R. (2001). Nicotine dependence in the United States: Prevalence, trends, and smoking persistence. Archives of General Psychiatry, 58, 810816.CrossRefGoogle ScholarPubMed
Broms, Y. U., Madden, P. A., Heath, A. C., Pergadia, M. L., Shiffman, S., & Kaprio, J. (2007). The Nicotine Dependence Syndrome Scale in Finnish smokers. Drug and Alcohol Dependence, 89, 4251.CrossRefGoogle ScholarPubMed
Clark, D. B., Wood, D. S., Martin, C. S., Cornelius, J. R., Lynch, K.G., & Shiffman, S. (2005). Multidimensional assessment of nicotine dependence in adolescents. Drug and Alcohol Dependence, 77, 235242.CrossRefGoogle ScholarPubMed
Costello, D., Dierker, L., Sledjeski, E., Flaherty, B., Flay, B., & Shiffman, S. (2007). Confirmatory factor analysis of the Nicotine Dependence Syndrome Scale in an American college sample of light smokers. Nicotine & Tobacco Research, 9, 811819.CrossRefGoogle Scholar
De Leon, J., Díaz, F. J., Becoña, E., Gurpegui, M., Jurado, D., & González-Pinto, A., (2003). Exploring brief measures of nicotine dependence for epidemiological surveys. Addictive Behaviors, 28, 14811486.CrossRefGoogle ScholarPubMed
Donny, E. C., & Dierker, L. C. (2007). The absence of DSM-IV nicotine dependence in moderate-to-heavy daily smokers. Drug and Alcohol Dependence, 89, 9396.CrossRefGoogle ScholarPubMed
Etter, J. F. (2005). A comparison of the content, contruct, and predictive validity of the Cigarette Dependence Scale and the Fagerström Test for Nicotine Dependence. Drug and Alcohol Dependence, 77, 259268.CrossRefGoogle Scholar
Fagerström, K. O. (1978). Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment. Addictive Behaviors, 3, 235241.CrossRefGoogle ScholarPubMed
Fagerström, K. O., Kunze, M., Schoberberger, R., Breslau, N., Hughes, J. R., Hurt, R. D. et al. , (1996). Nicotine dependence versus smoking prevalence: Comparisons among countries and categories of smokers. Tobacco Control, 5, 5256.CrossRefGoogle ScholarPubMed
First, M. B., Spitzer, R. L., Gibbon, M., Williams, J. B., & Smith-Benjamin, L. (1998). Guía del usuario de la entrevista clínica estructurada para los trastornos del eje I del DSM-IV- SCID-I [Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version]. Barcelona: Masson.Google Scholar
Franco, M. (2007). Análisis de curvas ROC: principios básicos y aplicaciones [Analysis of ROC curves: Basic principles and applications]. Madrid: La Muralla.Google Scholar
Hamblenton, R. K., Merenda, P. F., & Spielberger, C. D. (2005). Adapting educational and psychological tests for cross-cultural assessment. London: Lawrence Eribaum Associates.Google Scholar
Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerström, K. O. (1991). The Fagerström Test for Nicotine Dependence: A revision of the Fagerström Tolerance Questionnaire. British Journal of Addictions, 85, 11191127.CrossRefGoogle Scholar
Hughes, J. R., Helzer, J. E., & Lindberg, S. A. (2006). Prevalence of DSM/ICD-defined nicotine dependence. Drug and Alcohol Dependence, 85, 91102.CrossRefGoogle ScholarPubMed
Hughes, J. R., Oliveto, A. H., Riggs, R., Kenny, M., Kiguori, A., & MacLaughlin, M. A. (2004). Concordance of different measures of nicotine dependence: Two pilot studies. Addictive Behaviors, 29, 15271539.CrossRefGoogle ScholarPubMed
Kassel, J. D. (2000). Are adolescent smokers addicted to nicotine? The suitability of the nicotine dependence construct as applied to adolescents. Journal of Child and Adolescent Substance Abuse, 9, 2749.CrossRefGoogle Scholar
Kline, P. (1994). An easy guide to factor analysis. London: Routledge.Google Scholar
Nunnally, J. C. & Bersnstein, I. H. (1994). Psychometric theory. New York: McGraw-Hill.Google Scholar
Okuyemi, K. S., Pulvers, K. M., Cox, L. S., Thomas, J. L., Kaur, H., Mayo, M. S. et al. , (2007). Nicotine dependence among African American light smokers: A comparison of three scales. Addictive Behaviors, 32, 19892002.CrossRefGoogle ScholarPubMed
Piper, M. E., McCarthy, D. E., Bolt, D. M., Smith, S. S., Lerman, C., Benowitz, N. et al. , (2008). Assessing dimensions of nicotine dependence: An evaluation of the Nicotine Dependence Syndrome Scale (NDSS) and the Wisconsin Inventory of Smoking Dependence Motives (WISDM). Nicotine & Tobacco Research, 6, 10091020.CrossRefGoogle Scholar
Shiffman, S., Waters, A. J., & Hickcox, M. (2004). The Nicotine Dependence Syndrome Scale: A multidimensional measure of nicotine dependence. Nicotine & Tobacco Research, 6, 327348.CrossRefGoogle Scholar
United States Department of Health and Human Services (1988). The health consequences of smoking. Nicotine addiction. A report of the Surgeon General. Rockville, MD: United States Department of Health and Human Services.Google Scholar
United States Department of Health and Human Services (2004). The health consequences of smoking: A report of the Surgeon General. Atlanta, GA: United States 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.Google Scholar
West, R., Hajek, P., Stead, L., & Stapleton, J. (2005). Outcome criteria in smoking cessation trials: Proposal for a common standard. Addiction, 100, 299303.CrossRefGoogle ScholarPubMed
World Health Organization (1992). ICD-10: The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: World Health Organization.Google Scholar