[Tools for the assessment of tobacco dependence: comparison with questionnaires and marker assays]

Fagerström Tolerance Questionnaire has been questioned in some respects for the purpose of the evaluation of tobacco dependence. In a sample of 208 smokers attempting to quit, we measured on urinary samples the levels of nicotine metabolites via their thiobarbituric acid derivatives comparatively to the levels of nicotine and cotinine by high performance liquid chromatography. Urinary concentration of nicotine metabolites was 77.1 +/- 50.0 mumol/l. Nicotine and cotinine levels were respectively 8.2 +/- 12.0 mumol/l and 12.9 +/- 9.8 mumol/l. Spearman correlation coefficients were used to examine the relationships among various measures of exposure to cigarette smoke, tobacco markers and tobacco addiction scores obtained through the Fagerström Questionnaire and a Simplified Questionnaire. Nicotine metabolites are correlated with the score obtained with the Simplified Questionnaire (rho = 0.39) better than with the score of Fagerström (rho = 0.28) (p < 0.01). These moderate correlations suggest that the measurement of tobacco markers provide a more valuable information than questionnaires for the appreciation of the depth of tobacco intake. The questionnaires should not serve as a substitute for tobacco markers determination.