On the measurement of nicotine dependence in adolescence: Comparisons of the mFTQ and a DSM-IV-based scale

Objective To compare nicotine-dependent smokers identified by the modified Fagerstrom Tolerance Questionnaire (mFTQ) and a scale based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), in a multiethnic adolescent sample. Methods A school survey was conducted on 6th- to 10th-grade students (N = 15,007) in a large urban public school system. Results The two scales formed two distinct factors. The concordance between the two classifications of nicotine dependence was low. The DSM identified a much larger number of nicotine-dependent smokers than the mFTQ, mostly because smokers met dependence criteria at much lower levels of cigarettes consumed, especially when they were depressed. Rates of dependence were higher among whites than minority-group members, especially African Americans. Control for level of cigarette consumption attenuated or eliminated ethnic differences. Conclusions This investigation provides some understanding of youths defined as dependent by each scale but cannot by itself indicate which scale better measures dependence. Differences in dependence rates among ethnic groups are accounted for mostly by quantity of cigarettes smoked.