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Spanish Adaptation of the NDSS (Nicotine Dependence Syndrome Scale) and Assessment of Nicotine-Dependent Individuals at Primary Care Health Centers in Spain

Published online by Cambridge University Press:  10 January 2013

Elisardo Becoña*
Affiliation:
Universidad de Santiago de Compostela (Spain)
Ana López
Affiliation:
Universidad de Santiago de Compostela (Spain)
Elena Fernández del Río
Affiliation:
Universidad de Santiago de Compostela (Spain)
Mª Carmen Míguez
Affiliation:
Universidad de Santiago de Compostela (Spain)
Josefina Castro
Affiliation:
Servicio Andaluz de Salud (Spain)
*
Correspondence concerning this article should be addressed to Elisardo Becoña. Unidad de Tabaquismo. Universidad de Santiago de Compostela. Facultad de Psicología. Departamento de Psicología Clínica y Psicobiología. Campus sur. 15782 Santiago de Compostela. (Spain). E-mail: elisardo.becona@usc.es.

Abstract

The availability of adequate instruments for the assessment of nicotine dependence is an important factor that is relevant in the area of tobacco addiction. In this study, we present a Spanish validation of the Nicotine Dependence Syndrome Scale (NDSS) (Shiffman, Waters, & Hickcox, 2004). The sample was composed of patients, all daily smokers, who visited their General Practitioner (GP) at five Primary Health Care Centers in different cities of Spain (N = 637). The results indicated adequate reliability for the general factor that assesses nicotine dependence (NDSS-Total) (Cronbach's α = .76). Factor analysis confirms the five factors of the original validation: Drive, Continuity, Stereotypy, Priority, and Tolerance. It must be noted that reliability is adequate for the first, and moderate or low for the rest. The NDSS-T and its scales correlate significantly with the Fagerström Test for Nicotine Dependence (FTND), with the nicotine dependence criteria of the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) as assessed through the Structured Clinical Interview for DSM-IV (SCID), with carbon monoxide levels in expired air (CO), and with the number of cigarettes smoked. The ROC curve indicates that the NDSS-T has a score of .79 which is under the curve (.69 for the FTND), thus the prediction of nicotine dependence is adequate. We conclude that this instrument is useful (in terms of its total score NDSS-T) for assessing nicotine dependence for Spanish smokers (in Spain), as has been found in other countries, language groups, and cultures.

Disponer de adecuados instrumentos de evaluación de la dependencia de la nicotina es un aspecto relevante en el área de la adicción al tabaco. En este estudio se presenta la validación española de la Escala del Síndrome de la Dependencia de la Nicotina (NDSS, Shiffman, Waters y Hickcox, 2004). La muestra estuvo formada por fumadores diarios de cigarrillos que acudieron a su médico de Atención Primaria en cinco centros de salud de diferentes ciudades de España (N = 637). Los resultados indican una adecuada fiabilidad para el factor general que evalúa dependencia de la nicotina (NDSS-Total) (α de Cronbach = .76). El análisis factorial confirma los cinco factores obtenidos en la validación original de la escala: Impulso, Continuidad, Estereotipia, Prioridad y Tolerancia. La fiabilidad es adecuada para el primer factor, y moderada o baja para el resto de los factores. La NDSS-T y sus escalas correlacionan significativamente con el Test de Dependencia de la Nicotina de Fagerström (FTND), con los criterios de dependencia de la nicotina del Manual Diagnóstico y Estadístico de los Trastornos Mentales-IV (DSM-IV), evaluados mediante la Entrevista Clínica Estructurada para el DSM-IV (SCID-IV), con el nivel de monóxido de carbono en aire espirado (CO), y con el número de cigarrillos fumados al día. La curva ROC indica que la NDSS-T tiene una puntuación de .79 bajo la curva (.69 para el FTND), lo que indica que la predicción de la dependencia de la nicotina es adecuada. Se concluye que este instrumento es útil (en relación a la puntuación total NDSS-T) para evaluar la dependencia de la nicotina en fumadores españoles (en España), tal y como se ha encontrado en otros países, lenguas y culturas.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2010

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