Validity and reliability of the fagerstrom test for cigarette dependence in a sample of Arabic speaking UK-resident Yemeni khat chewers

Abstract

Background: The Fagerstrom Test for Cigarette Dependence (FTCD) (formally FTND) is widely used for measuring physical dependence on nicotine. Objective: To explore the cross cultural validity and reliability of FTCD amongst Arabic speaker cigarette consumers who chew khat leaf, a stimulant green leaf. Methods: The psychometric properties of the FTCD were assessed in a subsample (91regular cigarette smokers) of purposively selected 204 UK-resident Yemeni khat chewers recruited during random visits to khat sale outlets. Data were collected via a structured face-to-face interview. Data analyses included descriptive tests and factor analysis. Results: Two factors were obtained by a principle axis factor analysis and these were termed as urgency of restoring the level of nicotine after abstinence during sleeping and maintaining the level of nicotine during waking. The internal reliability (Cronbach's alpha coeffcient) of the whole FTCD is low (.68) as well as for the two subscales (.60) and (.62) respectively. Conclusion: The psychometric properties of the Arabic version of the FTCD scale in this sample of Yemeni khat chewers who smoked regularly confrmed what has been established in other cultural settings. The fndings of this study have yet to be cross validated amongst other appropriately representative sample of Arabic speakers.