Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI.
Department of Medicine and Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA.
Nicotine Tob Res. 2020 Apr 21;22(5):756-763. doi: 10.1093/ntr/ntz040.
Electronic cigarettes (e-cigarettes) have drastically changed the nicotine and tobacco product landscape. However, their potential public health impact is still unclear. A reliable and valid measure of e-cigarette dependence would likely advance assessment and prognostication of the public health impact of e-cigarettes. The aim of this research was to examine the internal consistency, structure, and validity of three e-cigarette dependence scales.
Adult dual users (smokers who also vape, N = 256) enrolled in an observational cohort study (45.1% women, 70.7% white). At baseline, participants completed the e-cigarette Fagerström Test of Cigarette Dependence (e-FTCD), the e-cigarette Wisconsin Inventory of Smoking Dependence Motives (e-WISDM), and the Penn State Electronic Cigarette Dependence Index (PS-ECDI). All participants provided a urine sample for cotinine analysis and reported e-cigarette use at 1 year.
The e-WISDM subscales had the highest internal consistency (α = .81-.96), then the PS-ECDI (α = .74) and e-FTCD (α = .51). A single-factor structure for the e-FTCD and an 11-factor structure for the e-WISDM were supported, but the PS-ECDI did not have a single-factor structure. All three e-cigarette dependence scales were highly correlated with validation criteria including continued e-cigarette use at 1 year, but not with e-liquid nicotine concentration or cotinine.
The e-WISDM and PS-ECDI had stronger internal consistency than did the e-FTCD, despite the e-FTCD's single-factor structure, but all 3 measures appear to be valid measures of e-cigarette dependence as suggested by their significant relations with self-perceived addiction, heavy use, early use after overnight deprivation, and continued use over time.
This research provides empirical support for three e-cigarette dependence measures: the e-FTCD, the PS-ECDI, and the e-WISDM among dual users of e-cigarettes and combustible cigarettes. The PS-ECDI and e-WISDM are more reliable, but all three measures were strongly correlated with key dependence constructs such as heavy use and continued use over time.
电子烟（e-cigarettes）极大地改变了尼古丁和烟草制品的格局。然而，它们对公众健康的潜在影响尚不清楚。一种可靠和有效的电子烟依赖衡量标准可能会促进对电子烟对公众健康影响的评估和预测。本研究旨在检验三种电子烟依赖量表的内部一致性、结构和有效性。
参加观察性队列研究的成年双重使用者（吸烟者，同时也使用电子烟，N = 256）。在基线时，参与者完成了电子烟 Fagerström 吸烟依赖性测试（e-FTCD）、电子烟威斯康星吸烟依赖性动机量表（e-WISDM）和宾夕法尼亚州立大学电子烟依赖性指数（PS-ECDI）。所有参与者都提供了尿液样本进行可替宁分析，并报告了 1 年内电子烟的使用情况。
e-WISDM 分量表的内部一致性最高（α =.81-.96），其次是 PS-ECDI（α =.74）和 e-FTCD（α =.51）。支持 e-FTCD 的单因素结构和 e-WISDM 的 11 因素结构，但 PS-ECDI 没有单因素结构。所有三种电子烟依赖量表都与验证标准高度相关，包括 1 年内继续使用电子烟，但与电子烟液尼古丁浓度或可替宁无关。
尽管 e-FTCD 具有单因素结构，但 e-WISDM 和 PS-ECDI 的内部一致性强于 e-FTCD，但所有 3 种测量方法似乎都是电子烟依赖的有效测量方法，因为它们与自我感知的成瘾、重度使用、一夜剥夺后早期使用和随时间持续使用有关。
本研究为电子烟和可燃香烟双重使用者的三种电子烟依赖测量方法提供了实证支持：e-FTCD、PS-ECDI 和 e-WISDM。PS-ECDI 和 e-WISDM 更可靠，但所有三种方法都与重度使用和随时间持续使用等关键依赖结构密切相关。
