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The Cigarette Withdrawal Scale CWS-21

Learn about the development and validation of the CWS-21 scale for measuring cigarette withdrawal symptoms using advanced psychometric methods. The study covers qualitative surveys, method details, results, and conclusions.

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The Cigarette Withdrawal Scale CWS-21

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  1. 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

  2. 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

  3. Objective To develop and assess the validity of a new, self-administered scale measuring cigarette withdrawal symptoms, using state-of-the-art psychometric methods

  4. 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

  5. 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

  6. 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)

  7. 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

  8. Reliability

  9. Relapse at 41 days: odds ratios

  10. Change 0-17 days in recent quitters

  11. Scores for various intervals post-quit

  12. Conclusions • CWS-21 is a reliable withdrawal scale, • performed well on tests of construct validity, • is sentitive to change over time • predicts relapse

  13. Get these slides and CWS-21 at: • STOP-TABAC.CH => Documents

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