Psychometric testing of the Chinese version of the Hooked on Nicotine Checklist in adolescents

J Adolesc Health. 2009 Sep;45(3):281-5. doi: 10.1016/j.jadohealth.2009.02.012. Epub 2009 May 9.


Purpose: To examine the psychometric properties of the Hooked on Nicotine Checklist (HONC) on a Taiwanese sample. The HONC as a measure of nicotine dependence in adolescents is in worldwide use. Less is known regarding its psychometric properties for a Chinese population.

Methods: A cross-sectional, descriptive study was conducted from January to May 2008 with 373 male adolescent smokers aged 15 to 20 years. The criterion validity of the Chinese HONC was determined using the Fagerstrom Test of Nicotine Dependence (FTND) and saliva cotinine. Because the responses to the items are dichotomous, the validity and factorial structures were examined using tetrachoric and biserial techniques by PRELIS 2 and LISREL 8.7.

Results: Most of interitem correlations are between 0.3 and 0.7. Each item is highly associated with the full scale (r > .7). The HONC total score is significantly associated with the FTND (r=.58, p < .01) and with saliva cotinine levels (r=.27, p < .05). Confirmatory factor analyses were performed to compare the relative fit of three competing models. The three-correlated factor model has a better fit than other models, according to the cutoff criteria for relatively good fit. The coefficient alpha of the full scale is .83.

Conclusions: The Chinese version of the HONC is a reliable and valid measure of tobacco dependence in adolescent smokers. Studies involving female adolescent and younger smokers will be needed to evaluate the applicability of the scales to the different genders and age populations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cross-Sectional Studies
  • Humans
  • Male
  • Psychometrics*
  • Reproducibility of Results
  • Taiwan / epidemiology
  • Tobacco Use Disorder / epidemiology*
  • Young Adult