National Drug Strategy
National Drug Strategy

Workplace Tobacco Management Project Research Findings (Evaluation) Report by Alcohol Tobacco and Other Drug Association ACT

Changes in nicotine dependence levels (mean Fagerstrom score and by category of dependence)

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This section of the findings examines and reports changes in smoking behavior among pilot sites. Measures included the use of the Fagerstrӧm Test for Nicotine Dependence (FTND), self reported addiction and ability to quit (smokers).

The FTND is a six-item questionnaire designed to measure the severity of nicotine dependence. The FTND has both high internal validity and test-retest reliability. The initial version, the Fagerstrom Tolerance Questionnaire (FTQ) was developed in the late 70ʼs (Fagerstrom 1978), with a revised version now more commonly used (Heatherton, Lynn et al. 1991). Since its development the FTND has been used to assess nicotine dependence across a number of intervention studies (Marques-Vidal, Kutalik et al. 2011), and has been used to assess probability of smoking cessation (Kozlowski, Porter et al. 1994).

Two methods of examining dependence are presented. Figure 8 presents the mean Fagerstrom score. The second presents the different categories of dependence (Figure 9). A reliability and factor analysis of the Fagerstrom Test for nicotine dependence is also included in Appendix 4. The reliability analysis shows that the FTND is an acceptable instrument for use amongst this population. The cronbach alpha coefficient of the FTND amongst this population was .705.

Figure 8: WPTMP Smoker mean FTND scores

WPTMP Smoker mean FTND scores. For detailed description of the image please refer to the descriptive link next to image D


Nicotine dependence categories

In addition to mean FTND scores, FTND categories are used by practitioners to determine the most appropriate level of NRT (patches) to use. Figure 9 shows:
Figure 9: Levels of nicotine dependence by survey period

Graphical presentation of the Levels of nicotine dependence by survey period. For detailed description please refer to the descriptive link next to the image D


Changes in levels of dependence categories

Also reported (Figure 10), are changes between low, low-moderate and Moderate to high nicotine dependence. Figure 10 shows that:
Figure 10: Changes in combined (low-low to moderate and moderate to high) categories of nicotine dependence by survey period

Changes in combined (low-low to moderate and moderate to high) categories of nicotine dependence by survey period. For detailed description please refer to the descriptive link next to the image D

Self reported level of addiction and ability to quit

After the baseline survey, some staff wanted to be able to self identify their level of nicotine addiction (independently of Fagerstrom) and ability to quit. Two additional questions were developed to assess this, the questions were:
1. If you think about how addicted you are to smoking, and 1=not addicted and 7=totally addicted, rate your addiction level.
2. If you think about how hard you think it would be to quit smoking, and 1=not hard at all and 7=impossible, rate how hard it would be for you to quit smoking.

Figure 11 shows that:
Figure 11: Perceived level of addiction and ability to quit amongst smokers

Graphical presentation of Perceived level of addiction and ability to quit amongst smokers. For detailed description of the image please refer to the descriptive link next to the image D


Smokers quit profiles

Smokers were asked about wanting to quit, whether they were organising a quit attempt, how many quit attempts they had made in their lifetime and if they had made any quit attempts in the 12 weeks preceding the survey. Figure 12 shows that:
Figure 12: WPTMP smokers quit profile and quit attempts by survey period

Graphical presentation of WPTMP smokers quit profile and quit attempts by survey period. For more detailed description please refer to the descriptive link next to the image D

Changes in smoking rates amongst smokers


Figure 13 shows that; Cochranʼs Q test showed that the reduction was not however statistically significant p=.519.

Figure 13: Pilot site staff smoker profile by survey period

Graphical presentation of Pilot site staff smoker profile by survey period. For detailed description please refer to the descriptive link next to the image D

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