Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111002

Scott, H. Frank, MD, MS, Division of Public Health, Case Western Reserve University, 10900 Euclid Ave., School of Medicine, WG-57, Cleveland, OH 44106, 216 368-3725, shf2@po.cwru.edu

Objective: This study examines the reliability and validity of the Smoker's CAGE (S-CAGE), a quantitative instrument for comprehensive assessment of tobacco use behavior in clinical and research settings. Methods: Current and former smokers (n=201) were recruited from nine family practice offices throughout the USA. Participants completed a 10-minute questionnaire including demographics; S-CAGE items; the Fagerstrom Tolerance Questionnaire (FTQ); and other health and smoking behaviors items. The S-CAGE items were analyzed using chi square; then subjected to data reduction utilizing principle component factor analysis with oblique rotation. Scales were created and Crohnbach's alpha computed. Correlations were utilized to assess relationships of the S-CAGE with smoking status, health variables, and smoking behaviors. T-tests were used to compare means for dichotomous variables while ANOVA served the same purpose for categorical variables. Results: The S-CAGE (alpha= .80) demonstrated strong psychometric properties and showed significant relationships with nicotine dependence variables including cessation difficulty (r= 0.55, p< .001) and tobacco related symptoms (r= 0.40, p< .001). These correlations were substantially higher than the FTQ. The S-CAGE reveals two domains: Affect Regulation Imperative (subscales: withdrawal dysphoria; affect related relapse; always smoke feelings; dysphoric affect toward abstinence; and dissonant tobacco use self image); and Physiologic Need for Nicotine (subscales or items: cigarettes per day; first cigarette of the day; nighttime smoking; and always smoke circumstances). Conclusion: The S-CAGE is a brief, highly reliable instrument with strong evidence of discriminant validity. Domains and subscales identified by the S-CAGE have utility for guiding treatment in the clinical setting.

Learning Objectives: The participant will

• Understand the structure and content of the Smoker’s CAGE, a comprehensive measure of nicotine dependence.
• Examine the psychometric reliability of the Smoker’s CAGE.
• Compare the validity of the Smoker’s CAGE to other commonly used measures of nicotine dependence.
• Recognize the functional utility of the domains and subscales described within the Smoker’s CAGE to guide cessation efforts in the clinical setting.
• Be prepared to utilize the Smoker's CAGE as a tool to support smoking cessation in clinical practice.

Keywords: Smoking, Primary Care

Presenting author's disclosure statement:

Not Answered