Diagnostics of nicotine dependence in Quitline counseling work

Tatiana Andreeva
Alcohol and Drug Information Center (ADIC-Ukraine)

In Quitline counseling work several first words are extremely important for the success of the contact. So the ability of the consultant to quickly diagnose stage of readiness and nicotine dependence of the client influences the whole process. So most informative first questions are valuable.
The results of first four months of Quitline functioning in Ukraine are analyzed for the purpose of this study. 776 smokers applied by telephone call and 220 by mail.

To diagnose tobacco dependence questions about number of cigarettes smoked per day, years of smoking, previous attempts to quit and results, time of the first cigarette were asked. Fagerstrom test (FT) was used with those who applied by mail and those where the level of dependence was not clear.

The question about time of the first cigarette proved to be the most informative one. It's results correspond to the results of other questions mentioned above. Several groups were identified according to the time of the first cigarette of a day.

1. Night smokers - those who wake up at night to smoke (8%). FT is 7 or higher. >25 cig/day. The youngest age of smoking initiation, the longest years of smoking, though the age does not differ from other groups. The largest proportion of those with more than 3 attempts to quit. 

2. Those who smoke as soon as awake. The largest group (50%). 20-25 cig/day, FT 6 or higher.

3. Those who smoke after breakfast (28%). FT 4-5, 15-20 cig/day. Usually only one attempt to quit. The only group where smokers tried to reduce the number of cigarettes. Emphasize the importance of manipulations with cigarette and the use of smoking to cope with stress.

4. Those who smoke on their way to their workplace or school. The youngest group with the shortest length of smoking. FT 4.

These groups are a continuum of different levels of nicotine dependence.