연구배경 금연 프로그램에서 니코틴 의존도 측정은 필수적인 항목이며, 이를 위해 FTND(Fagerstrom Test for Nicotine Dependence)가 대표적으로 사용되고 있다. FTND에서 ‘일 평균 흡연량’과 ‘아침 첫 담배까지의 시간’으로 구성된 HSI(Heavy Smoking Index) 설문은 이미 외국에서 그 타당도와 유용성이 입증되었으나 아직 국내 연구는 없는 실정이다. 이번 연구는 FTND와 HSI를 비교하여 HSI를 역학 조사나 금연 프로그램에서 사용할 수 있는지 평가하였다. 방 법 2007년 4월 전국 250개 보건소에 등록한 8,547명을 대상으로 사회 인구학적 변수와 흡연력을 조사하고 FTND 설문을 실시하였다. FTND 설문의 2항목을 HSI로 구성하여 그 총점을 계산하였으며, FTND와 HSI의 상관관계를 조사하였고, 두 도구 간의 일치도를 Cohen's kappa 값을 계산하여 분석하였으며, FTND에 대한 HSI의 민감도와 특이도를 조사하였다. ‘일 평균 흡연량’과 ‘아침 첫 담배까지의 시간’의 개별 항목이 니코틴 의존도 평가에 유용한지를 FTND에 대해 같은 방법으로 조사하였다. 결 과 평균 연령은 44세, 평균 체질량 지수는 23.7Kg/m2이었으며, 흡연량은 1갑 미만이 3/4를, 흡연기간은 절반 이상이 10-29년 사이였다. FTND와 HSI의 평균은 각각 4.6과 3.0으로 나타났으며, 두 변수간의 상관 계수는 0.91로 높게 나타났다. 두 도구 간의 일치도는 Cohen's kappa값이 0.71로 높게 나타났으며, FTND에 대해 HSI로 니코틴 의존도가 높은 군을 평가할 때의 민감도와 특이도는 89%와 84%로 높게 나타났다. 2가지 개별 항목을 각각 단일 도구로 평가했을 때는 kappa값과 민감도, 특이도가 HSI에 미치지 못했다. 결 론 2항목으로 구성되는 HSI는 니코틴 의존도가 높은 군을 선별할 수 있는 합리적인 도구이며, 대규모 역학 조사나 짧은 평가 시간이 필요한 상황에서 효과적으로 사용될 수 있다.

Background Measuring nicotine dependence is an essential part of smoking cessation program. for which FTND is widely used. Heavy Smoking Index which is consisted of 'daily amounts of cigarette' and 'time to first cigarette' has already been proved as a valid tool, but there isn't no comparable study in Korea. It aims to verify the usefulness of HSI in comparison of FTND, especially in the area of mass survey and clinics. Methods We gathered socio-demographic factors and smoking history from those who visited 250 public health centers, and took FTND questionnaire. We analysed the correlation between FNTD and HSI, and calculated the Cohen's kappa coefficient to analyse the degree of agreement. And We calculated the sensitivity and specificity of HSI in according to FTND. We investigated whether each item could be useful for nicotine dependence measuring, as mentioned. Results The mean age of 8547 subjects is 44, and mean BMI is 23.7Kg/m2. The mean of total score of HSI is 3.0, and that of FTND is 4.6. Pearson correlation coefficient between HSI and FTND is 0.91, which is evaluated as high score. Cohen's kappa coefficient is 0.71 which reflects high agreement between two tools. The sensitivity and specificity of HSI is 89% and 84%, respectively, in according to FTND. The Cohen's kappa coefficient, sensitivity and specificity of each item is not reached for HSI Conclusions HSI which is consisted of 2 items is a reasonable substitute for the FTND, and may be efficiently used in the mass survey and the rapidly evaluating tool.

Background Measuring nicotine dependence is an essential part of smoking cessation program. for which FTND is widely used. Heavy Smoking Index which is consisted of 'daily amounts of cigarette' and 'time to first cigarette' has already been proved as a valid tool, but there isn't no comparable study in Korea. It aims to verify the usefulness of HSI in comparison of FTND, especially in the area of mass survey and clinics. Methods We gathered socio-demographic factors and smoking history from those who visited 250 public health centers, and took FTND questionnaire. We analysed the correlation between FNTD and HSI, and calculated the Cohen's kappa coefficient to analyse the degree of agreement. And We calculated the sensitivity and specificity of HSI in according to FTND. We investigated whether each item could be useful for nicotine dependence measuring, as mentioned. Results The mean age of 8547 subjects is 44, and mean BMI is 23.7Kg/m2. The mean of total score of HSI is 3.0, and that of FTND is 4.6. Pearson correlation coefficient between HSI and FTND is 0.91, which is evaluated as high score. Cohen's kappa coefficient is 0.71 which reflects high agreement between two tools. The sensitivity and specificity of HSI is 89% and 84%, respectively, in according to FTND. The Cohen's kappa coefficient, sensitivity and specificity of each item is not reached for HSI Conclusions HSI which is consisted of 2 items is a reasonable substitute for the FTND, and may be efficiently used in the mass survey and the rapidly evaluating tool.

smoking, nicotine dependence, measuring