A confirmatory factor analysis of the Fagerstrom Test for Nicotine Dependence

This study used confirmatory factor analysis (CFA) to compare the relative fit of the following competing measurement models of the Fagerstrom Test for Nicotine Dependence (FTND): a single factor; two correlated factors (morning smoking and daytime smoking); and two correlated factors with one-item cross-loading. A single factor five-item version and a single factor four-item version of the FTND were also tested with the knowledge that these were not nested within the original six-item model. The subjects consisted of 231 smokers admitted for pre-surgical assessment at a large urban teaching hospital. The results confirm the findings of previously published exploratory factor analyses (EFA) suggesting that the items of the FTND are best modeled as two correlated factors with a cross-loading. Given the origin of the FTND items as measures of physical dependence, the degree to which it has undergone largely data-driven modifications, and the confirmed complex structure of the items, it is recommended that researchers re-examine the extent to which the scale adequately represents current conceptualizations of nicotine dependence.