1. ¹Institute of Social and Preventive Medicine, University of Geneva, Switzerland
2. ²Pharmacia R&D Consumer Healthcare, Helsingborg, Sweden
3. ³Quality of Care Unit, Geneva University Hospitals, Switzerland

Correspondence: J-F Etter, Institute of Social and Preventive Medicine, University of Geneva, CMU, Case Postale, CH-1211 Geneva 4, Switzerland. Tel: +41 22 702 59 19; Fax: +41 22 702 59 12; E-mail: Jean-Francois.Etter@imsp.unige.ch. Internet: www.stop-tabac.ch

Received 20 February 2002; Revised 10 June 2002; Accepted 10 July 2002.

Abstract

A valid measure of dependence on cigarettes is a useful tool for clinicians and researchers. The aim of this study was to develop a new, self-administered measure of cigarette dependence, and to assess its validity. The content of the instrument was generated in qualitative surveys. A long version (114 items) was tested on the internet in 3009 smokers. Subsamples provided retest data after 18 days (n=578), follow-up data after 45 days (n=990) and saliva cotinine (n=105). The study resulted in a 12-item scale labelled the Cigarette Dependence Scale (CDS-12), and in a 5-item version of this scale (CDS-5). Except for tolerance, CDS-12 covers the main components of DSM-IV and ICD-10 definitions of dependence: compulsion, withdrawal symptoms, loss of control, time allocation, neglect of other activities, and persistence despite harm. CDS-5 has similar measurement properties but less comprehensive content. Both scales had a high test–retest reliability (r0.83), and a high internal consistency (Cronbach's 0.84). CDS-12 scores were higher in daily smokers than in occasional smokers (+1.3SD units), and were associated with the strength of the urge to smoke during the last quit attempt (R²0.25), and with saliva cotinine (R²0.17). CDS-12 and CDS-5 scores decreased in daily smokers who switched to occasional smoking at 18-day retest. Dependence scores did not predict smoking abstinence at follow-up. In conclusion, CDS-12 and CDS-5 are reliable measures of cigarette dependence which fulfill several criteria of content validity and construct validity and are sensitive to change over time.