PURPOSE: “Social nicotine dependence” is defined as cognitive distortions of smoking, for example, denying the ill effects of smoking or rationalization and the justification of smoking as cultural and social behavior. It can be quantified by the “ Kano Test for Social Nicotine Dependence (KTSND)”, which has 10 questions with a total score of 30. In order to evaluate the psychological aspects of patients who quit smoking, we applied this test at the beginning of and at the end of a 12-week smoking cessation program.
METHODS: Ninety six patients, who had successfully finished a 12-week smoking cessation program between August 2008 and March 2011, were chosen as test subjects. At the end of the program, patients were divided into two groups, namely, group A (n = 56); those who don’t want to smoke anymore and don’t envy smokers, and group B (n = 40); those who still want to smoke and/or envy smokers. KTSND, Tobacco Dependence Screener (TDS), and Fagerstrom Test for Nicotine Dependence (FTND) etc. were compared in the two groups.
RESULTS: At the beginning of the program, the total KTSND scores of 16.2 ± 5.3 (mean ± SD) for group B were significantly higher than those of 13.9 ± 5.9 for group A. However there was no significant difference in age, pack-year, TDS, and FTND between the two groups. At the end of a 12-week program, the total KTSND scores of 13.4 ± 5.3 for group B were significantly higher than those of 9.1 ± 6. 6 for group A. In both groups, the total KTSND scores at the beginning significantly decreased at the end of a 12-week program.
CONCLUSIONS: The psychological state of group A patients seemed to be almost the same as non-smokers. On the other hand, even though group B patients succeeded in the cessation of smoking using medication, their psychological state is similar to smokers.
CLINICAL IMPLICATIONS: The KTSND is a useful tool to quantify psychological changes among patients who quit smoking. However long term follow up is necessary to confirm it.
DISCLOSURE: The following authors have nothing to disclose: Chiharu Yoshii, Fumio Kunitomo, Masato Kano, Toshinori Kawanami, Chinatsu Nishida, Shuya Nagata, Kazuhiro Yatera, Hiroshi Mukae
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