Gender Differences in the Fagerström Test for Nicotine Dependence in Korean Americans

INTRODUCTION: This study was conducted to compare gender differences in the psychometric properties of the Fagerström Test for Nicotine Dependence (FTND). METHODS: The sample comprised 334 Korean immigrants (97 women and 237 men) who reported daily smoking for the past six months. Item-by-item responses and exploratory factor analyses (EFA) were compared by gender. Promax rotation was selected based on findings from previous studies suggesting correlated factors. RESULTS: Compared with men, women smoked fewer cigarettes per day, were more likely to smoke when ill in bed, and were less likely to smoke frequently in the morning. The entire sample and men within the sample had the same factor loading pattern, where three items (time to first cigarette, the cigarette most hate to give up, and smoke more frequently in the morning) were loaded on Factor 1 (morning smoking) and the remaining three items (difficult to refrain from smoking in public places, number of cigarettes smoked per day, and smoking even when ill in bed) on Factor 2 (daytime smoking). For women, however, neither the 1- nor 2-factor model fit the data well. CONCLUSIONS: For Korean American male smokers, the psychometric properties of the FTND were similar to those seen in other populations, but this was not the case with Korean American women. Clinicians may need to modify their interpretation of nicotine dependence severity if basing only on the FTND with Korean Women. The FTND assesses smoking patterns which has a cultural influence and other measures of nicotine dependence should be considered.