{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T06:41:14Z","timestamp":1774334474626,"version":"3.50.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["PRCRPG-Nov21\\100002"],"award-info":[{"award-number":["PRCRPG-Nov21\\100002"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Nicotine dependence measures often rely on self-reported cigarette consumption, which has declined over time and may not accurately reflect nicotine intake. We developed a brief two-item Short Nicotine Dependence Index (SNDI) assessing urge to use and difficulty abstaining, and examined its association relative to that of the established Heaviness of Smoking Index (HSI) with saliva cotinine, a biomarker of nicotine exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were drawn from the Health Survey for England (HSE; 2000\u20132021) and a London General Practice Survey (GP Survey; 1989) (n\u00a0=\u200914\u2009244 current cigarette smokers aged \u226516 with valid cotinine data). Dependence was assessed using two questions: time to first cigarette after waking (scored 1\u20136) and perceived difficulty going a whole day without smoking (scored 0\u20133). Scores were summed to produce a total SNDI score (range 1\u20139). Mean cotinine levels were estimated across item responses and total scores in each sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cotinine concentrations increased consistently with higher scores on both individual items and the total SNDI score. In the HSE, cotinine ranged from 83 [95% CI\u2009=\u200977% to 88%] ng\/mL for those with the lowest total score to 387 [377\u2013396] ng\/mL for those with the maximum score. A similar gradient was observed in the GP Survey (from 92 [75\u2013110] to 431 [399\u2013463]), despite higher overall cigarette consumption. In both datasets, the SNDI explained more variance in cotinine than the HSI: R2\u00a0=\u20090.304 vs. 0.278; GP Survey: 0.283 vs. 0.250.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SNDI is a brief self-report measure that outperforms existing short tools in predicting nicotine exposure. It offers a practical alternative for research and community surveillance in evolving nicotine use landscapes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>The Short Nicotine Dependence Index offers an efficient and practical alternative to traditional dependence measures that rely on cigarette consumption. Its brevity and strong correlation with biochemical markers make it well-suited for use in large-scale surveys and clinical settings. By focusing on observed behavior (time to first cigarette) and self-reported difficulty abstaining, it remains relevant as smoking and nicotine use patterns shift. In addition, because it does not use reported cigarettes smoked per day, it may be useful for assessing dependence on other nicotine products (eg, e-cigarettes). Further research is needed to evaluate its validity among users of other nicotine products.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntaf204","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T11:48:53Z","timestamp":1759837733000},"page":"602-608","source":"Crossref","is-referenced-by-count":1,"title":["The Short Nicotine Dependence Index: A Simple and Versatile Self-Report Measure of Nicotine Dependence for General Populations"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5658-6168","authenticated-orcid":false,"given":"Sarah E","family":"Jackson","sequence":"first","affiliation":[{"name":"Department of Behavioural Science and Health, University College London , London ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Tattan-Birch","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health, University College London , London ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Stapleton","sequence":"additional","affiliation":[{"name":"Independent Statistician"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin J","family":"Jarvis","sequence":"additional","affiliation":[{"name":"Department of Behavioural Science and Health, University College London , London ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"2026032400164985100_ref1","volume-title":"Adult Smoking Habits in the UK: 2023","author":"Office for National Statistics","year":"2024"},{"issue":"2","key":"2026032400164985100_ref2","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.drugalcdep.2006.04.004","article-title":"Prevalence of DSM\/ICD-defined nicotine dependence","volume":"85","author":"Hughes","year":"2006","journal-title":"Drug Alcohol Depend"},{"issue":"8","key":"2026032400164985100_ref3","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1080\/08870446.2017.1325890","article-title":"Tobacco smoking: health impact, prevalence, correlates and interventions","volume":"32","author":"West","year":"2017","journal-title":"Psychol Health"},{"issue":"4","key":"2026032400164985100_ref4","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/0306-4603(86)90024-9","article-title":"Some methodological cautions in the use of the tolerance questionnaire","volume":"11","author":"Lichtenstein","year":"1986","journal-title":"Addict Behav"},{"issue":"4","key":"2026032400164985100_ref5","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1016\/S0899-3289(20)30011-0","article-title":"Nicotine dependence and the Fagerstr\u00f6m tolerance questionnaire: a brief review","volume":"1","author":"Pomerleau","year":"1989","journal-title":"J Subst Abus"},{"issue":"7","key":"2026032400164985100_ref6","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1111\/j.1360-0443.1989.tb03059.x","article-title":"Measuring the heaviness of smoking: using self-reported time to the first cigarette of the day and number of cigarettes smoked per day","volume":"84","author":"Heatherton","year":"1989","journal-title":"Br J Addict"},{"issue":"9","key":"2026032400164985100_ref7","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1111\/j.1360-0443.1991.tb01879.x","article-title":"The Fagerstr\u00f6m test for nicotine dependence: a revision of the Fagerstrom tolerance questionnaire","volume":"86","author":"Heatherton","year":"1991","journal-title":"Br J Addict"},{"key":"2026032400164985100_ref8","first-page":"123","volume-title":"Methods for Evaluating Tobacco Control Policies. IARC Handbooks of Cancer Prevention","author":"International Agency for Research on Cancer","year":"2008"},{"issue":"4","key":"2026032400164985100_ref9","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1093\/ntr\/ntae071","article-title":"Trends in daily cigarette consumption among smokers: a population study in England, 2008\u20132023","volume":"27","author":"Jackson","year":"2025","journal-title":"Nicotine Tob Res"},{"issue":"3","key":"2026032400164985100_ref10","doi-asserted-by":"publisher","first-page":"e0282893","DOI":"10.1371\/journal.pone.0282893","article-title":"Trends in cigarette consumption across the United States, with projections to 2035","volume":"18","author":"Leas","year":"2023","journal-title":"PLoS One"},{"issue":"2","key":"2026032400164985100_ref11","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1046\/j.1360-0443.1999.94226910.x","article-title":"Validity of the Fagerstrom test for nicotine dependence and of the heaviness of smoking index among relatively light smokers","volume":"94","author":"Etter","year":"1999","journal-title":"Addiction."},{"issue":"4","key":"2026032400164985100_ref12","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1136\/tobaccocontrol-2016-053601","article-title":"Trends in cigarette consumption and time to first cigarette on awakening from 2002 to 2015 in the USA: new insights into the ongoing tobacco epidemic","volume":"27","author":"Goodwin","year":"2018","journal-title":"Tob Control"},{"issue":"12","key":"2026032400164985100_ref13","doi-asserted-by":"publisher","first-page":"1620","DOI":"10.1093\/ntr\/ntu120","article-title":"Variation in nicotine intake among U.S. cigarette smokers during the past 25 years: evidence from NHANES surveys","volume":"16","author":"Jarvis","year":"2014","journal-title":"Nicotine Tob Res"},{"key":"2026032400164985100_ref14","article-title":"Cotinine per cigarette smoked: health survey for England, 1993-2019","author":"Jarvis","year":"2024"},{"issue":"5","key":"2026032400164985100_ref15","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1111\/add.16757","article-title":"The price of a cigarette: 20 minutes of life?","volume":"120","author":"Jackson","year":"2025","journal-title":"Addiction."},{"issue":"6186","key":"2026032400164985100_ref16","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1136\/bmj.2.6186.357","article-title":"Self-titration by cigarette smokers","volume":"2","author":"Ashton","year":"1979","journal-title":"Br Med J"},{"issue":"6219","key":"2026032400164985100_ref17","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1136\/bmj.280.6219.972","article-title":"Relation of nicotine yield of cigarettes to blood nicotine concentrations in smokers","volume":"280","author":"Russell","year":"1980","journal-title":"Br Med J"},{"key":"2026032400164985100_ref18","author":"Jackson"},{"issue":"2","key":"2026032400164985100_ref19","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1093\/ntr\/ntae021","article-title":"Trends in exclusive non-cigarette tobacco smoking in England: a population survey 2013\u20132023","volume":"27","author":"Jackson","year":"2024","journal-title":"Nicotine Tob Res"},{"key":"2026032400164985100_ref20","doi-asserted-by":"publisher","first-page":"e079016","DOI":"10.1136\/bmj-2023-079016","article-title":"Trends in long term vaping among adults in England, 2013-23: population based study","volume":"386","author":"Jackson","year":"2024","journal-title":"BMJ."},{"issue":"6","key":"2026032400164985100_ref21","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1038\/clpt.1984.117","article-title":"Blood cotinine levels as indicators of smoking treatment outcome","volume":"35","author":"Hall","year":"1984","journal-title":"Clin Pharmacol Ther"},{"issue":"2","key":"2026032400164985100_ref22","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1136\/jech.42.2.111","article-title":"District programme to reduce smoking: can sustained intervention by general practitioners affect prevalence?","volume":"42","author":"Russell","year":"1988","journal-title":"J Epidemiol Community Health"},{"issue":"12","key":"2026032400164985100_ref23","doi-asserted-by":"publisher","first-page":"1458","DOI":"10.1093\/ntr\/ntp161","article-title":"Interlaboratory comparability of serum cotinine measurements at smoker and nonsmoker concentration levels: a round-robin study","volume":"11","author":"Bernert","year":"2009","journal-title":"Nicotine Tob Res"},{"issue":"5","key":"2026032400164985100_ref24","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1038\/clpt.1994.169","article-title":"Metabolism of nicotine to cotinine studied by a dual stable isotope method","volume":"56","author":"Benowitz","year":"1994","journal-title":"Clin Pharmacol Ther"},{"key":"2026032400164985100_ref25","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/978-3-540-69248-5_2","article-title":"Nicotine chemistry, metabolism, kinetics and biomarkers","volume":"192","author":"Benowitz","year":"2009","journal-title":"Handb Exp Pharmacol"},{"issue":"3","key":"2026032400164985100_ref26","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1080\/1462220031000094213","article-title":"Measuring nicotine intake in population surveys: comparability of saliva cotinine and plasma cotinine estimates","volume":"5","author":"Jarvis","year":"2003","journal-title":"Nicotine Tob Res Off J Soc Res Nicotine Tob"},{"issue":"Suppl 4","key":"2026032400164985100_ref27","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1080\/14622200701673480","article-title":"Time to first cigarette in the morning as an index of ability to quit smoking: implications for nicotine dependence","volume":"9","author":"Baker","year":"2007","journal-title":"Nicotine Tob Res Off J Soc Res Nicotine Tob."},{"issue":"12","key":"2026032400164985100_ref28","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.1093\/ntr\/nts018","article-title":"The Fagerstr\u00f6m test for nicotine dependence as a predictor of smoking abstinence: a pooled analysis of varenicline clinical trial data","volume":"14","author":"Fagerstr\u00f6m","year":"2012","journal-title":"Nicotine Tob Res Off J Soc Res Nicotine Tob"},{"issue":"1","key":"2026032400164985100_ref29","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1186\/s12916-024-03635-1","article-title":"Trends in non-daily cigarette smoking in England, 2006\u20132024","volume":"22","author":"Jackson","year":"2024","journal-title":"BMC Med"},{"issue":"3-4","key":"2026032400164985100_ref30","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1080\/13547500310012545","article-title":"Clinical considerations in study designs that use cotinine as a biomarker","volume":"8","author":"Bramer","year":"2003","journal-title":"Biomarkers."}],"container-title":["Nicotine and Tobacco Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntaf204\/64549548\/ntaf204.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/28\/4\/602\/64549548\/ntaf204.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/28\/4\/602\/64549548\/ntaf204.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T04:17:33Z","timestamp":1774325853000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ntr\/article\/28\/4\/602\/8277634"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,8]]},"references-count":30,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,10,8]]},"published-print":{"date-parts":[[2026,3,24]]}},"URL":"https:\/\/doi.org\/10.1093\/ntr\/ntaf204","relation":{},"ISSN":["1469-994X"],"issn-type":[{"value":"1469-994X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2025,10,8]]}}}