Spanish Adaptation of the NDSS (Nicotine Dependence Syndrome Scale) and Assessment of Nicotine-Dependent Individuals at Primary Care Health Centers in Spain

The availability of adequate instruments for the assessment of nicotine dependence is an important factor that is relevant in the area of tobacco addiction. In this study, we present a Spanish validation of the Nicotine Dependence Syndrome Scale (NDSS) (Shiffman, Waters, & Hickcox, 2004). The sample was composed of patients, all daily smokers, who visited their General Practitioner (GP) at five Primary Health Care Centers in different cities of Spain (N = 637). The results indicated adequate reliability for the general factor that assesses nicotine dependence (NDSS-Total) (Cronbach's α = .76). Factor analysis confirms the five factors of the original validation: Drive, Continuity, Stereotypy, Priority, and Tolerance. It must be noted that reliability is adequate for the first, and moderate or low for the rest. The NDSS-T and its scales correlate significantly with the Fagerström Test for Nicotine Dependence (FTND), with the nicotine dependence criteria of the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) as assessed through the Structured Clinical Interview for DSM-IV (SCID), with carbon monoxide levels in expired air (CO), and with the number of cigarettes smoked. The ROC curve indicates that the NDSS-T has a score of .79 which is under the curve (.69 for the FTND), thus the prediction of nicotine dependence is adequate. We conclude that this instrument is useful (in terms of its total score NDSS-T) for assessing nicotine dependence for Spanish smokers (in Spain), as has been found in other countries, language groups, and cultures. Disponer de adecuados instrumentos de evaluación de la dependencia de la nicotina es un aspecto relevante en el área de la adicción al tabaco. En este estudio se presenta la validación española de la Escala del Síndrome de la Dependencia de la Nicotina (NDSS, Shiffman, Waters y Hickcox, 2004). La muestra estuvo formada por fumadores diarios de cigarrillos que acudieron a su médico de Atención Primaria en cinco centros de salud de diferentes ciudades de España (N = 637). Los resultados indican una adecuada fiabilidad para el factor general que evalúa dependencia de la nicotina (NDSS-Total) (α de Cronbach = .76). El análisis factorial confirma los cinco factores obtenidos en la validación original de la escala: Impulso, Continuidad, Estereotipia, Prioridad y Tolerancia. La fiabilidad es adecuada para el primer factor, y moderada o baja para el resto de los factores. La NDSS-T y sus escalas correlacionan signif