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National Cancer Institute
Behavioral Research - Cancer Control and Population Sciences

NCI Measures Guide for Youth Tobacco Research

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Modified Version of the Fagerstrom Tolerance Questionnaire (mFTQ)
Prokhorov et al.

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Brief Description: This modified version of the FTQ (Fagerstrom, 1978) assesses the level of nicotine dependence among adolescents. The instrument uses a 5-point Likert scale for all seven items, except for one item on smoking during the first two hours of the day. The original FTQ item, assessing nicotine content in the respondent's "usual" brand of cigarettes, was excluded from this adolescent version.
Target Population: Adolescents aged 14 to 20
Administrative Issues: Computer administered or paper and pencil 7-item, self-report questionnaire
Scoring Information: Scoring Information: Time Required: Minimal
A total score is obtained by summing raw scores, as outlined by scoring codes, for each item. Scoring codes were designed to make the scores of every individual item comparable with those of the original FTQ.

Cut-offs, indicating level of dependence, for the total score are as follows:
    0-2 = no dependence
    3-5 = moderate dependence
    6-9 = substantial dependence
Psychometrics: Based on 110 teens from a vocational-technical school.
Factor analyses yielded one general factor.
Internal consistency: Cronbach alpha = .75

Validity estimates
    Association with duration of smoking (in years): r = 0.36
    Association with smoking intensity (Minnesota Smoking Index): r = 0.45
    Association with saliva cotinine (Prokhorov et al., 2000): r = 0.40

Test-retest reliability (Prokhorov et al., 1998): r = 0.71 (2-month interval)

Clinical Utility of Instrument: The mFTQ could be used to identify a subset of adolescents who may benefit from more intensive forms of smoking cessation treatment.
Research Applicability: This is a reliable measure for assessing nicotine dependence in adolescents. The mFTQ can be used as a continuous index of dependence or to classify participants into one of 3 levels of dependence.
Copyright, Cost, andSource Issues: There is no charge for this measure.
Source Reference: Prokhorov, A.V., Pallonen, U.E., Fava, J.L., Ding, L., & Niaura, R. (1996). Measuring nicotine dependence among high-risk adolescent smokers. Addictive Behaviors, 21(1), 117-127.
Supporting References: Prokhorov, A.V., Koehly, L.M., Pallonen, U.E., & Hudmon, K.D. (1998). Adolescent nicotine dependence measured by the Modified Fagerstrom Tolerance Questionnaire at two time points. Journal of Child and Adolescent Substance Abuse, 7(4), 35-47.

Prokhorov, A.V., DeMoor, C., Pallonen, U.E., Hudmon, K.S., Koehly, L., & Hu, S. (2000). Validation of the Modified Fagerstrom Tolerance Questionnaire with salivary cotinine among adolescents. Addictive Behaviors, 25(3), 429-433.
Corresponding Author: Alexander V. Prokhorov, M.D., Ph.D.
Contact Information: Department of Behavioral Science, MD
Anderson Cancer Center
The University of Texas
1515 Holcombe Blvd., Box 243
Houston, TX 77030.
  * Fagerstrom, K.O. (1978). Measuring the degree of physical dependency to tobacco smoking with reference to individualization of treatment. Addictive Behaviors, 3, 235-241.
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Last Updated: May 1, 2012

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