Validity and Reliability of Kano Test for Social Nicotine Dependence

Purpose“Social nicotine dependence” is a newly-coined phrase for describing a psychological and psychosocial state associated with smoking. That new dependence is defined as a misperception of smoking caused by smokers' attempts, for example, to deny the ill effects of tobacco and/or to justify themselves by regarding smoking as acceptable cultural and social behavior. It can be quantified by a 10-item questionnaire, the Kano Test for Social Nicotine Dependence (KTSND). We examined the internal consistency as well as the criterion-related and construct validity and factor structure of KTSND.MethodsSelf-administered questionnaires including the KTSND, smoking status, and stages in quitting smoking only for current smokers were collected from 666 industrial workers.ResultsThe internal consistency of the KTSND assessed by Cronbach's α coefficient was 0.77. In addition, we found that an 8-item combination from among 10 items had a higher coefficient of 0.80. KTSND scores differed among three groups of smoking status as a criterion. Factor analysis clarified two potential factors: “an overestimation of smoking's effects to enhance physical and mental status” and “an insistence on smoking as acceptable cultural and social behavior.”ConclusionThe KTSND proved to be valid in terms of the internal consistency and the inclusion of two key aspects of the misperception of smoking.