The Cigarette Withdrawal Scale
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The Cigarette Withdrawal Scale CWS-21. Jean-François E T T E R, PhD Institute of social and preventive medicine Faculty of Medicine University of Geneva Switzerland. Background. Valid measurement is essential to science

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The Cigarette Withdrawal ScaleCWS-21

Jean-François E T T E R, PhD

Institute of social and preventive medicine

Faculty of Medicine

University of Geneva

Switzerland


Background

  • Valid measurement is essential to science

  • Comprehensive validation studies are lacking, for most withdrawal scales

  • Available scales were developed in UK or USA, and may not reflect situation in other countries

  • Some widely used scales are not recent: - Minnesota Withdrawal Scale (Hughes) = 1986 - Shiffman-Jarvik = 1976


Objective

To develop and assess the validity of a new,

self-administered scale measuring

cigarette withdrawal symptoms,

using state-of-the-art psychometric methods


Qualitative survey: methods

  • Questionnaires sent out by mail to a representative population sample in Geneva, n=2,000

  • "Please describe how a smoker feels when he is deprived of nicotine"

  • 404 answers from smokers and ex-smokers


Qualitative survey: results

  • Nervous, impatient 288

  • Irritable, bad mood, frustrated 158

  • Urgent, strong need to smoke 116

  • Somatic signs (various) 91

  • Anxiety, fear 72

  • Stressed 57

  • Difficulty concentrating 51

  • Increased appetite 48

  • Depressed, sad 29

  • Insomnia, fatigue 26


Methods

  • Qualitative data + theory (DSM, ICD) = 61 items

  • 5-point Likert scales (agree-disagree)

  • Survey on STOP-TABAC.CH, in French

  • N=3,050

  • Retest after 17 days (n=118)

  • Follow-up after 41 days (n=1,119)


Results

  • 21-item scale

  • 6 dimensions, cover DSM-IV and ICD-10

  • Sound factor structure (bootstrap resampling)

  • Depression-Anxiety

  • Craving

  • Irritability- Nervousness-Impatience

  • Appetite-Weight Gain

  • Insomnia

  • Difficulty Concentrating






Conclusions

  • CWS-21 is a reliable withdrawal scale,

  • performed well on tests of construct validity,

  • is sentitive to change over time

  • predicts relapse


Get these slides and CWS-21 at:

  • STOP-TABAC.CH => Documents


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