Diaz Francisco J, Jané Mireia, Saltó Esteve, Pardell Hélios, Salleras Lluís, Pinet Cristina, de Leon Jose
Mental Health Research Center at Eastern State Hospital, Lexington, KY 40508, USA.
Aust N Z J Psychiatry. 2005 Mar;39(3):161-8. doi: 10.1080/j.1440-1614.2005.01538.x.
It is important to perform a routine screening of nicotine dependence in psychiatric patients. The Fagerstrom Test for Nicotine Dependence (FTND) is a widely used six-item questionnaire. The Heavy Smoking Index (HSI) is a briefer measure including only two FTND items (time to first cigarette of day and number of daily cigarettes). In a prior study comparing HSI with FTND, a high HSI (score > or = 4) was a good and briefer alternative for detecting high nicotine dependence. The goals of this study were: (i) to compare the effectiveness of the HSI with the effectiveness of Items 1 and 4 alone for the screening of high nicotine dependence; (ii) to investigate the optimality of 4 as a cut-off score for the HSI so that the HSI can be used as a binary indicator of high nicotine dependence; and (iii) to compare the sensitivity and specificity of four indexes of high nicotine dependence, namely 'High HSI', 'Very Early Smoking', 'Heavy Smoking' and 'High in Either Item'.
The FTND was administered to 819 current daily smokers from a general population survey. As in a prior study, an FTND score > or = 6 was considered the reference or 'gold standard' test for detecting high nicotine dependence. Receiver-operating characteristic analyses were performed.
This new study using more sophisticated statistical methodology verified that a cut-off of 4 for the HSI is appropriate and that the 'high' HSI has good sensitivity and specificity even across different population subclassifications.
With four questions (smoking, daily smoking, time to first cigarette of day and number of daily cigarettes) and minimal calculations, it may be possible to screen whether a smoker has high nicotine dependence. If other studies in other populations and settings verify this finding, this brief measure might be an ideal screening instrument for busy clinicians, epidemiologists developing questionnaires for health surveys and psychiatric researchers.
对精神病患者进行尼古丁依赖的常规筛查很重要。尼古丁依赖的Fagerstrom测试（FTND）是一种广泛使用的六项问卷。重度吸烟指数（HSI）是一种更简短的测量方法，仅包括FTND的两个项目（每天第一支烟的时间和每日吸烟量）。在之前一项比较HSI与FTND的研究中，高HSI（得分≥4）是检测高尼古丁依赖的一种简便且有效的替代方法。本研究的目的是：（i）比较HSI与仅使用项目1和4筛查高尼古丁依赖的有效性；（ii）研究将4作为HSI的临界值的最优性，以便HSI可作为高尼古丁依赖的二元指标；（iii）比较高尼古丁依赖的四个指标，即“高HSI”、“极早吸烟”、“重度吸烟”和“任一项目得分高”的敏感性和特异性。
对来自一项普通人群调查的819名每日吸烟者进行FTND测试。与之前的研究一样，FTND得分≥6被视为检测高尼古丁依赖的参考或“金标准”测试。进行了受试者工作特征分析。
这项采用更复杂统计方法的新研究证实，HSI的临界值为4是合适的，并且即使在不同人群亚组中，“高”HSI也具有良好的敏感性和特异性。
通过四个问题（吸烟情况、每日吸烟量、每天第一支烟的时间和每日吸烟支数）以及最少的计算，有可能筛查吸烟者是否有高尼古丁依赖。如果其他人群和环境中的研究验证了这一发现，那么这种简短的测量方法可能是忙碌的临床医生、为健康调查制定问卷的流行病学家以及精神病学研究人员的理想筛查工具。
