Abstract
The objective of this study was to evaluate the reliability and validity of the Chinese mainland version of the Fagerström Test for Nicotine Dependence (CFTND), compare the Heavy Smoking Index (HSI) to the CFTND, and identify determinants of nicotine dependence among rural Chinese males. A sample of 1759 males ages 15 years and older was drawn from two regions in rural China using a multi-stage systematic sampling procedure. Nicotine dependence of respondents was assessed using the six-item CFTND in a face-to-face interview. Of 1759 respondents, 1211 (69%) were current smokers. Of smokers, 17% were nicotine dependent. The CFTND showed moderate reliability (Cronbach alpha: 0.64) in our sample. Items from the CFTND loaded on two factors in a factor analysis: Factor 1 by “hating most to give up the first cigarette in the morning” and “smoking while ill” and Factor 2 by the remaining four items. Multiple logistic regression analysis identified the following determinants of nicotine dependence in the study group: region: Xuzhou (OR = 2.04) versus Baoshan; age: 45 years and older (OR = 1.86) versus < 25 years; daily cigarette consumption: smoking 20+ (OR = 1.55) or 30+ (OR = 5.23) versus <10; age at smoking initiation: 25+ years (OR = 0.39) versus <18; smoking situation: with others (OR = 0.63) versus alone; and stage of intention-to-quit: action (OR = 0.44) versus pre-contemplation. Possessing important implications for designing appropriate smoking-cessation interventions, CFTND appears to be an acceptable tool for measuring nicotine dependence among rural Chinese.