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Volume 19, Issue 11, Pages 815-822 (November 2009)


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Validity and Reliability of Kano Test for Social Nicotine Dependence

Tetsuya Otani, MD, PhDajCorresponding Author Informationemail address, Chiharu Yoshii, MD, PhDbj, Masato Kano, MD, PhDcj, Masako Kitada, MSdj, Koji Inagaki, DDS, PhDej, Narito Kurioka, MDfj, Takeshi Isomura, MD, PhDgj, Megumi Hara, MD, PhDhj, Yukitoshi Okubo, MD, PhDi, Hiroshi Koyama, MD, PhDa

Received 17 November 2008; accepted 5 March 2009. published online 20 May 2009.

Purpose

“Social nicotine dependence” is a newly-coined phrase for describing a psychological and psychosocial state associated with smoking. That new dependence is defined as a misperception of smoking caused by smokers' attempts, for example, to deny the ill effects of tobacco and/or to justify themselves by regarding smoking as acceptable cultural and social behavior. It can be quantified by a 10-item questionnaire, the Kano Test for Social Nicotine Dependence (KTSND). We examined the internal consistency as well as the criterion-related and construct validity and factor structure of KTSND.

Methods

Self-administered questionnaires including the KTSND, smoking status, and stages in quitting smoking only for current smokers were collected from 666 industrial workers.

Results

The internal consistency of the KTSND assessed by Cronbach's α coefficient was 0.77. In addition, we found that an 8-item combination from among 10 items had a higher coefficient of 0.80. KTSND scores differed among three groups of smoking status as a criterion. Factor analysis clarified two potential factors: “an overestimation of smoking's effects to enhance physical and mental status” and “an insistence on smoking as acceptable cultural and social behavior.”

Conclusion

The KTSND proved to be valid in terms of the internal consistency and the inclusion of two key aspects of the misperception of smoking.

a Department of Public Health, Graduate School of Medicine, Gunma University, Maebashi, Japan

b Division of Respiratory Disease, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan

c Department of Internal Medicine, Shin-nakagawa Hospital, Yokohama, Japan

d Faculty of Commercial Science, Sapporo Gakuin University, Ebetsu, Japan

e Department of Dental Hygiene, Aichi-Gakuin University Junior College, Nagoya, Japan

f Department of Internal Medicine, Johoku Hospital, Kyoto, Japan

g Reset Behavioral Research Group, Nagoya, Japan

h Department of Preventive Medicine, Faculty of Medicine, Saga University, Saga, Japan

i Corporate Human Resources Division, Mitsubishi Electric Corporation, Tokyo, Japan

j The Kano Test for Social Nicotine Dependence (KTSND) Working Group in Research Group on Smoke-Free Psychology, Japan

Corresponding Author InformationAddress correspondence to: Tetsuya Otani, Department of Health Policy, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan.

PII: S1047-2797(09)00091-X

doi:10.1016/j.annepidem.2009.03.016


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