Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Addict Behav. 2012 Nov;37(11):1271-7. doi: 10.1016/j.addbeh.2012.06.011. Epub 2012 Jun 21.
Smokeless tobacco (ST) use is associated with tobacco dependence and long-term adverse health consequences. Clinical and research tools that can accurately assess ST dependence are needed to improve research and treatment of ST users. Measures of ST dependence have been developed to address this need. We used data from a study evaluating the effectiveness of bupropion sustained release for the treatment of ST use (N=225) to compare the Fagerström Tolerance Questionnaire for Smokeless Tobacco (FTQ-ST) users, the Severson Smokeless Tobacco Dependency Scale (SSTDS), and the Glover-Nilsson Smokeless Tobacco Behavioral Questionnaire (GN-STBQ). We observed that despite the intention of the scale: (1) all scales were significantly correlated with ST cans consumed per week; (2) the FTQ-ST was significantly correlated with serum nicotine and cotinine concentrations and craving; (3) the GN-STBQ and SSTDS were significantly associated with both craving and withdrawal; and (4) none of the scales were significantly associated with ST abstinence. When all of the scales were entered simultaneously in a multivariable analysis, the SSTDS was the only scale independently associated with withdrawal and craving. As when used with cigarette smokers, the FTQ-ST appeared to measure the construct of physical dependence. The GN-STBQ and SSTDS, designed to measure broader constructs of dependence, were found to predict both withdrawal and craving which may be advantageous in clinical settings. The GN-STBQ and the FTQ-ST did not contribute significantly to the prediction of withdrawal and craving beyond what was accomplished using the SSTDS. The use of the scales is discussed in terms of clinical usefulness and how each scale might assess differing aspects of tobacco dependence.
无烟烟草（ST）的使用与烟草依赖和长期不良健康后果有关。需要能够准确评估 ST 依赖的临床和研究工具，以改善 ST 用户的研究和治疗。已经开发了衡量 ST 依赖的措施来满足这一需求。我们使用了一项评估丁胺苯丙酮缓释剂治疗 ST 使用效果的研究（N=225）的数据，比较了无烟烟草 Fagerström 耐受性问卷（FTQ-ST）、塞弗森无烟烟草依赖量表（SSTDS）和格洛弗-尼尔森无烟烟草行为问卷（GN-STBQ）。我们观察到，尽管这些量表的目的是：（1）所有量表都与每周消耗的 ST 罐数显著相关；（2）FTQ-ST 与血清尼古丁和可替宁浓度和渴望显著相关；（3）GN-STBQ 和 SSTDS 与渴望和戒断都显著相关；（4）没有一个量表与 ST 戒断显著相关。当所有量表同时进入多变量分析时，SSTDS 是唯一与戒断和渴望相关的量表。与用于吸烟人群时一样，FTQ-ST 似乎测量了身体依赖的结构。GN-STBQ 和 SSTDS 旨在测量更广泛的依赖结构，被发现可以预测戒断和渴望，这在临床环境中可能是有利的。GN-STBQ 和 FTQ-ST 对戒断和渴望的预测并没有超过 SSTDS 的贡献。讨论了这些量表的临床用途，以及每个量表如何评估烟草依赖的不同方面。
