Measuring the loss of autonomy over nicotine use in adolescents - The DANDY (development and assessment of nicotine dependence in youths) study
Measuring the loss of autonomy over nicotine use in adolescents - The DANDY (development and assessment of nicotine dependence in youths) study
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DOI：
10.1001/archpedi.156.4.397
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发表时间：
2002-04-01
影响因子：
--
通讯作者：
Wood, C
中科院分区：
文献类型：
--
作者：
DiFranza, JR;Savageau, JA;Wood, C
背景：没有经过验证的、基于理论的工具来评估尼古丁依赖的发作。然而，所有成瘾物质的使用都可能导致自主性的丧失。我们提出尼古丁依赖始于自主性丧失时，即当烟草使用的后遗症，无论是身体上的还是心理上的，都成为戒烟的障碍时。目的：检验尼古丁依赖的自主性理论，并评估尼古丁成瘾检查表（HONC）作为衡量烟草使用自主性丧失的指标。设计：在一项为期30个月的前瞻性纵向研究中，对679名七年级学生的烟草使用自然史进行了评估。正如假设的那样，在HONC上认可单个项目与戒烟尝试失败有关（比值比[OR]，29; 95%置信区间[CI]，13-65），持续吸烟直至随访结束（OR，44; 95%CI，17-114）和每日吸烟（OR，58; 95%CI，24-142）。HONC评分与最大吸烟量（r = 0.65; P <0.001）和最大吸烟频率（r = 0.79; P <0.001）相关。内部可靠性为0.94。一个1因素的解决方案解释了66%的总variance.Conclusions：数据支持的自主性理论，依赖开始与自主性的丧失。自主性理论代表了一个潜在的有用的替代目前的概念，尼古丁依赖的青少年，和HONC似乎衡量失去了自主性的青少年。结构效度证明其效用预测戒烟失败和烟草使用的进展。此外，心理测量特性也非常出色。
Context: There is no validated, theory-based tool for assessing the onset of nicotine dependence. However, the use of all addictive substances can result in a loss of autonomy. We propose that nicotine dependence begins when autonomy is lost, ie, when the sequelae of tobacco use, either physical or psychological, present a barrier to quitting.Objectives: To test the autonomy theory of nicotine dependence, and to evaluate the Hooked on Nicotine Checklist (HONC) as a measure of the loss of autonomy over tobacco use.Design: The psychometric performance and concept validity of the HONC were evaluated in a 30-month prospective longitudinal study of the natural history of tobacco use in a cohort of 679 seventh-grade students.Results: As hypothesized, endorsement of a single item on the HONC was associated with a failed attempt at smoking cessation (odds ratio [OR], 29; 95% confidence interval [CI], 13-65), continued smoking until the end of follow-up (OR, 44; 95% CI, 17-114), and daily smoking (OR, 58; 95% CI, 24-142). Scores on the HONC correlated with the maximum amount smoked (r = 0.65; P < .001) and the maximum frequency of smoking (r = 0.79; P < .001). Internal reliability was 0.94. A 1-factor solution explained 66% of the total variance.Conclusions: The data support the autonomy theory that dependence begins with the loss of autonomy. The autonomy theory represents a potentially useful alternative to current concepts of nicotine dependence for adolescents, and the HONC appears to measure lost autonomy in adolescents. Construct validity was demonstrated by its utility in predicting failed cessation and the progression of tobacco use. In addition, the psychometric properties were excellent.