Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
INSPECT-LB: Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.
Environ Sci Pollut Res Int. 2021 Jun;28(22):28407-28414. doi: 10.1007/s11356-021-12667-6. Epub 2021 Feb 4.
Vulnerable adolescents may lose control over cigarette use within a day or two after smoking their first cigarette, as nicotine dependence (ND) symptoms may appear before actual daily smoking and usually occur at low levels of daily smoking. Moreover, smoking can cause illnesses and promote other types of substance abuse. Therefore, it was deemed essential to adapt the Young Adults' Cigarette Dependence (YACD) Scale to develop and validate the Adolescent Cigarette Dependence Scale (ACDS) in Lebanese adolescents and evaluate whether cumulative cigarette smoking is associated with nicotine dependence and symptoms of dependence. A cross-sectional study was carried out between August and September 2020, during the partial sanitary lockdown imposed by the government to limit COVID-19, coinciding with the summer holidays for most Lebanese. The total sample consisted of 564 community-dwelling adolescents aged 13 to 18. A factor analysis was performed using a varimax rotation. The Kaiser-Meyer-Olkin (KMO) measurement of sampling adequacy and Bartlett's sphericity test were appropriate. The factors retained corresponded to Eigenvalues > 1. Cronbach's alpha value represented the internal consistency of the scale. The Hooked on Nicotine Checklist (HONC) was used to screen for dependence symptoms. All items of the YACD were extracted, except for items 4 (smoking to concentrate at work) and 18 (smoking as a habit), which yielded a three-factor solution (factor 1 = smoking patterns; factor 2 = positive and negative reinforcements; factor 3 = smoking cessation) with Eigenvalues > 1 (variance explained = 56.18%; KMO = 0.784; Bartlett's sphericity test p < 0.001; α = 0.875). The newly generated scale was termed Adolescent Cigarette Dependence Scale (ACDS) and consisted of 19 items. Higher ACDS scores (higher cigarette dependence) were significantly associated with higher HONC scores (higher symptoms of dependence) (rho = 0.647; p < 0.001). Having deceased (B = 8.54) or divorced (B = 4.26) parents and higher cumulative cigarette smoking (B = 0.29) were significantly associated with higher ACDS scores. Higher cumulative cigarette smoking (B = 0.05) was significantly associated with higher HONC scores due to cigarettes. This study could validate a new tool to evaluate nicotine dependence among Lebanese adolescents, the Adolescent Cigarette Dependence Scale (ACDS). This version adapted from the Young Adults' Cigarette Dependence (YACD) Scale is reliable and valuable and correlates well with other scales, such as the HONC. However, further studies are necessary to improve this instrument, adding new questions useful for the diagnosis and evaluation of cigarette dependence.
易受影响的青少年可能在吸第一支烟后的一到两天内就失去对香烟的控制，因为尼古丁依赖（ND）症状可能在实际每天吸烟之前出现，而且通常发生在每天吸烟量较低的情况下。此外，吸烟会导致疾病并促进其他类型的物质滥用。因此，有必要调整青少年香烟依赖量表（YACD），以开发和验证黎巴嫩青少年的青少年香烟依赖量表（ACDS），并评估累积吸烟量是否与尼古丁依赖和依赖症状有关。2020 年 8 月至 9 月期间进行了一项横断面研究，当时政府实施了部分卫生封锁以限制 COVID-19 的传播，这与大多数黎巴嫩人的暑假时间一致。总样本由 564 名年龄在 13 至 18 岁之间的社区居住的青少年组成。使用方差极大旋转进行因子分析。Kaiser-Meyer-Olkin（KMO）抽样充分性测量和 Bartlett 的球形检验是合适的。保留的因子对应于特征值> 1。克朗巴赫的α值代表了量表的内部一致性。使用尼古丁依赖检查表（HONC）筛查依赖症状。提取了 YACD 的所有项目，除了项目 4（吸烟集中注意力）和项目 18（吸烟作为一种习惯），这些项目产生了一个特征值> 1 的三因素解决方案（因素 1 =吸烟模式；因素 2 =正和负强化；因素 3 =戒烟）（方差解释 = 56.18%；KMO = 0.784；Bartlett 的球形检验 p < 0.001；α = 0.875）。新生成的量表被称为青少年香烟依赖量表（ACDS），由 19 个项目组成。较高的 ACDS 分数（较高的香烟依赖）与较高的 HONC 分数（较高的依赖症状）显著相关（rho = 0.647；p < 0.001）。父母一方去世（B = 8.54）或离婚（B = 4.26）和更高的累积吸烟量（B = 0.29）与更高的 ACDS 分数显著相关。更高的累积吸烟量（B = 0.05）与由于香烟导致的更高的 HONC 分数显著相关。本研究可以验证一种新的工具来评估黎巴嫩青少年的尼古丁依赖程度，即青少年香烟依赖量表（ACDS）。这个版本是从青少年香烟依赖量表（YACD）改编而来的，是可靠的，有价值的，与其他量表（如尼古丁依赖检查表（HONC））相关性良好。然而，还需要进一步的研究来改进这个工具，增加对香烟依赖的诊断和评估有用的新问题。
