Development and psychometric evaluation of the psychological cigarette dependence scale for male smokers in Taiwan

Background: The influence of psychological factors on cigarette dependence often surpasses the direct effects of the nicotine itself. Researcher opinions on the nature and extent of psychological contributors to cigarette dependence vary widely. Purpose: This study develops and psychometrically tests the Psychological Cigarette Dependence Scale (PCDS) for male smokers in Taiwan. Methods: The PCDSwas developed using domain identification, individual interviews for item generation, expert reviews, and testing for construct validity and instrument stability. After initial item analysis, the PCDSwas tested for concurrent and construct validity and reliability on 256 adult male smokers recruited from community centers, trade and business organizations, private companies, and factories in southern Taiwan. Participants were limited to adultmen because female smokers are a small (4.1%) proportion of the female population in Taiwan and thus are difficult to recruit in statistically significant numbers. Results: Exploratory factor analysis showed that lifelong binding and health concerns are the two predominating factors addressed by the 37-item PCDS. The PCDS correlated positively with the Fagerstrom questionnaire (r = .54, p < .01). Cronbach's alpha was .94, and test-retest reliability (intraclass coefficient) was .77 (N = 28). Conclusions/Implications for Practice: Preliminary evidence suggests that this scale is a valid measure of psychological cigarette dependence. Assessment results may help nursing professionals focus on smoking cessation interventions that are tailored to the patterns and severity of patients' psychological cigarette dependence.