Heaviness of Smoking Index versus Fagerstrom Test for Nicotine Dependence among Current Smokers of Ahmedabad City, India

Background: The purpose of this research was to compare Heaviness of Smoking Index (HSI), high earlysmoking, and heavy smoking with the Fagerstrom Test for Nicotine Dependence (FTND) and further toevaluate the sensitivity of HSI, high early smoking, and heavy smoking among existing smokers.Methods: A cross sectional study was conducted by using FTND questionnaire among ۲۰۰ existing smokers. Thecut-off point for HSI was kept at ۴; high early smokers and heavy smokers were classified as those individualswho smoked within ۳۰ minutes after waking up and individuals who smoked ۳۰ cigarettes or more daily,respectively. Receiver-operating characteristic (ROC) analysis and Cohen's Kappa statistics were evaluated.Findings: A significant agreement was observed between the HSI and the FTND, having Kappa value of ۰.۷۰,with good sensitivity of ۷۸.۱۶% and specificity as high as ۹۱.۱۵%. The ROC analysis confirmed that a cut-offscore of ۴ for HSI was suitable. Agreement between FTND and high early smoking was observed to be moderate(Kappa = ۰.۴۷, P < ۰.۰۰۱), while very low agreement (Kappa = ۰.۱۹, P < ۰.۰۰۱) was observed for FTND andheavy smoking.Conclusion: Results show that HSI is an effective tool which can be substituted for the conventional FTND bythe clinicians, psychotherapists, and investigators in health research.

Keywords:

tobacco use disorder , Sensitivity and specificity , Tobacco Smoking , Screening