Comparing the validity of the Cigarette Dependence Scale and the Fagerström Test for Nicotine Dependence

Drug Alcohol Depend. 2008 May 1;95(1-2):152-9. doi: 10.1016/j.drugalcdep.2008.01.017. Epub 2008 Mar 6.


Background: We compared the validity of the Cigarette Dependence Scale (CDS-12) and of the Fagerström Test for Nicotine Dependence (FTND) in daily cigarette smokers.

Methods: Internet survey in 2004-2007. Eight days and 6 weeks after answering these two dependence questionnaires, participants indicated their smoking status and answered the Cigarette Withdrawal Scale and the Smoking Self-Efficacy Questionnaire. We used the Mini International Neuropsychiatric Interview (MINI) to assess nicotine dependence as defined in DSM-IV.

Results: There were 13,697 participants at baseline, 1113 (8%) after 8 days and 435 (3%) after 6 weeks. CDS-12, but not FTND, predicted smoking cessation after 8 days (odds ratio=1.20 per standard deviation unit, p=0.03) and 6 weeks (odds ratio=1.34, p=0.01). In participants who had quit smoking after 8 days, CDS-12 was a better predictor of craving (beta=0.30, p<0.001), than FTND (beta=0.14, p<0.01). After 8 days, self-efficacy in quitters was predicted by CDS-12 (beta=-0.16, p=0.02), but not by FTND (beta=-0.05, p=0.3). CDS-12 was more strongly associated than FTND with DSM-defined dependence measured by MINI: area under the Receiver Operating Characteristic (ROC) curve=0.72 (95% confidence interval=0.70-0.73). For FTND, the area under ROC=0.64 (0.63-0.66).

Conclusions: CDS-12 performed better than FTND on tests of predictive and construct validity.

MeSH terms

  • Adult
  • Cues
  • Female
  • Follow-Up Studies
  • Health Surveys
  • Humans
  • Internet
  • Male
  • Motivation
  • Nicotine / toxicity*
  • Psychometrics / statistics & numerical data
  • Reproducibility of Results
  • Self Efficacy
  • Smoking / psychology*
  • Smoking Cessation / psychology*
  • Social Environment
  • Substance Withdrawal Syndrome / diagnosis*
  • Substance Withdrawal Syndrome / psychology
  • Surveys and Questionnaires*
  • Switzerland
  • Tobacco Use Disorder / diagnosis*
  • Tobacco Use Disorder / psychology
  • Tobacco Use Disorder / rehabilitation


  • Nicotine