• DiFranza et al. (2002)
• Originally created for the longitudinal Development and Assessment of Nicotine Dependence in Youth (DANDY) survey, for use with adolescents.
• Measures initial symptoms of nicotine dependence (defined as lost autonomy over one’s tobacco use).
• HONC-9 version
Type of Measure:
• Self-completed or interview
• 10 items
• Summed total.
• Answering yes to 1 or more items = nicotine dependence.
Source reference: DiFranza et al. (2002): 30 month longitudinal study with 679 seventh-grade students (332 used tobacco) in Massachusetts, U.S.A.
• Reliability: High internal consistency (Cronbach’s alpha = 0.94); Test-retest of the HONC total: k = 0.61.
• Validity: HONC scores correlated with maximum amount smoked (r = 0.65) and maximum frequency of smoking (r = 0.79).
• Unifactorial, accounting for 66% of variance.
Wellman, DiFranza, et al. (2006): 215 adolescent smokers taken from a larger sample in a Massachusetts study.
• Reliability: Cronbach’s alpha = 0.92; Test-retest after 6 months and after 1 year showed a high stability of scores, with an ICC of 0.93 and 0.91, respectively.
• Validity: Correlation with the Modified Fagerström Tolerance Questionnaire at baseline was high (r = 0.83); both measures also correlated similarly with number of cigarettes smoked on a smoking day (r = 0.69), however, the correlation of the HONC with the number of smoking days in the last month was lower (r = 0.68) compared to that of the MFTQ (r = 0.76).
Wellman, Savageau, et al. (2006): 1,130 adult smokers in communities of Massachusetts, U.S.A.
• Reliability: Cronbach’s alpha = 0.82, indicating high internal consistency.
• Validity: Correlation between the HONC and the Fagerström Test for Nicotine Dependence was moderate (r = 44); both measures had similar correlations with the number of smoking days per month (r = 0.22 for the HONC, and r = 0.25 for the FTND).
Wheeler et al. (2004): 88 ninth-grade students in Massachusetts, U.S.A.
• Reliability: Cronbach’s alpha = 0.90; Test-retest after 2 weeks for the entire HONC is very good (intraclass correlation (ICC) = 0.88); Individual item internal consistency over time ranged from 0.41- 0.82, indicating good to excellent reliability.
• Reliability: Correlated with self-reports of smoking (r = 0.70).
Utility for Prevalence Surveys:
• Good – short, easy to administer, and cut-scores available.
Copyright, Cost, and Source Issues:
• Available in source reference.
DiFranza, J. R., Savageau, J. A., Fletcher, K., Ockene, J. K., Rigotti, N. A., McNeill, A. D., Coleman, M., & Woods, C. (2002). Measuring the loss of autonomy over nicotine use in adolescents: The development and assessment of nicotine dependence in youth (DANDY) study. Archives of Pediatrics & Adolescent Medicine, 156(4), 397-403.
Wellman, R. J., DiFranza, J. R., Pbert, L., Fletcher, K. E., Flint, A., Young, M. H., & Druker, S. (2006). A comparison of the psychometric properties of the hooked on nicotine checklist and the modified Fagerström tolerance questionnaire. Addictive Behaviors, 31(3), 486-495.
Wellman, R. J., Savageau, J. A., Godiwala, S., Savegau, N., Friedman, K., Hazelton, J., & DiFranza, J. R. (2006). A comparison of the hooked on nicotine checklist and the Fagerström test for nicotine dependence in adult smokers. Nicotine & Tobacco Research, 8(4), 575-580.
Wheeler, K. C., Fletcher, K. E., Wellman, R. J., & DiFranza, J. R. (2004). Screening adolescents for nicotine dependence: The hooked on nicotine checklist. Journal of Adolescent Health, 35(3), 225-230.
• Adult and adolescent measure.
• Clear conceptual model.
• Good psychometric support.
• Racial and ethnic diversity of validation samples is limited.
• Used mostly with adolescents.