Nicotine dependence and urge to smoke predict negative health symptoms in smokers

Objective To assess the predictive value of nicotine dependence or urge to smoke for negative health symptoms one year later. Methods Subjects were smokers (N = 1519) from the US, Canada, UK, France and Spain participating in the internet based ATTEMPT study between 2004 and 2006, a multi-national prospective cohort study. Nicotine dependence was assessed by the Fagerström Test for Nicotine Dependence (FTND) and urge to smoke by the 10-item version of the Questionnaire of Smoking Urges (QSU-10). Specific questions were used to assess presence of chest pain specified as angina pectoris, shortness of breath, depressive mood, feeling of anxiety and visit at a primary care physician, an index of global health and health care, one year after assessment of FTND and QSU-10. Results Smokers who reported angina pectoris, shortness of breath, low mood, anxiety or visit at a primary care physician 9 to 12 months after assessment have significantly higher FTND and QSU-10 scores than those who did not report these negative health symptoms or who did not visit a primary care physician. Conclusion Smokers with high level of nicotine dependence or urge to smoke are at higher risk of negative health symptoms than those who have low levels of nicotine dependence or urge to smoke.