Evaluation Of Social Nicotine Dependence Using The Kano Test For Social Nicotine Dependence (Ktsnd-K) Questionnaire In Korea

Background: Smoking is one of the most important leading causes of morbidity and mortality. Smoking habit is recognized as nicotine dependence, which consists of physical and psychosocial dependence. To evaluate social nicotine dependence, the Kano Test for Social Nicotine Dependence (KTSND) working group developed a new questionnaire, which consists of 10 questions with a total score of 30 in Japan. We examined the social nicotine dependence among healthy adults using the new KTSND questionnaire and evaluated validity of the KTSND questionnaire in Korea.Method: We applied Korean KTSND questionnaire version 2 to employees of hospital, university students and people for medical examination and promotion test. Complete data obtained from the 741 responders were analyzed.Result: The mean age of responders was 31.8 years. Among them, males were 57.8%. Current smokers, ex-smokers, and non-smokers were 13.8%, 12.8%, and 73.4% respectively. According to smoking status, the total KTSND scores of current smokers were significantly higher than those of ex-smokers, and of non-smokers (17.1 +/- 5.4 versus 14.3 +/- 5.5, and 12.3 +/- 5.5, p <= 0.001). The total KTSND scores of males were higher than those of females, suggesting that males have a propensity for depending nicotine socially much more than females (14.3 +/- 5.7 and 11.7 +/- 5.4 respectively, p<0.001). Eight of ten questions produced significantly different scores among three different smoking groups. When current smokers were sub-classified by heavy smoking index (HSI) that represented physical nicotine dependence, we did not find a significant difference of KTSND score between low HSI group (< 4) and high HSI group (>= 4), This finding suggested that the psychosocial dependence might play a different role from physical nicotine dependence in smoking. Most of the non-smokers (62.5%) had an experience of harmful passive smoking especially in public place.Conclusion: Our study suggested that the KTSND questionnaire could be a useful method to evaluate psychosocial aspects of smoking.