Academic journal article Journal of Nursing Measurement

Psychometric Properties of the Minnesota Nicotine Withdrawal Scale: A Korean Version

Academic journal article Journal of Nursing Measurement

Psychometric Properties of the Minnesota Nicotine Withdrawal Scale: A Korean Version

Article excerpt

Smoking is considerably more common among Korean American male individuals compared with all U.S. males, but no reliable and valid nicotine withdrawal scale has been available to measure withdrawal symptoms from the Korean American perspective, which is the aim of the present study. Translation and back-translation of the Minnesota Nicotine Withdrawal Scale (MNWS) was conducted to obtain a measure consistent with the Korean cultural understanding of smoking withdrawal symptoms. Following satisfactory interrater agreements, the Korean version (MNWS-K) was administered to 118 Korean American male smokers. Data were analyzed for internal consistency reliability and stability as well as construct validity. Internal consistency reliability was satisfactory for the total scale and factors (.88, .88, .79) and intraclass correlation coefficient (ICC) for the total score over a 1-month period was fair (r = .51). Exploratory factor analysis with orthogonal rotation yielded two factors. Together, Factor I, early-occurring disturbances in mental functioning, and Factor II, disturbances in physiological functioning and lateoccurring disturbances in mental functioning, explained 66% of the variance in the scale. Theoretically related variables to the MNWS-K, number of smoking quit attempts and selfefficacy, showed modest but statistically significant correlations with the MNWS-K total and factored scales. Satisfactory internal consistency coefficients together with the validity findings suggest the MNWS-K warrants use with the Korean American population.

Keywords: nicotine withdrawal; smoking; Korean Americans; Minnesota Tobacco Withdrawal Scale; psychometric properties

Tobacco use, mostly cigarette smoking, is the single leading preventable cause of death in the United States (U.S. Department of Health and Human Services [USDHHS], 2004). About 8.6 million people have at least one serious illness caused by smoking, a pernicious habit that leads to more than 440,000 deaths each year, or one in every five deaths, resulting in annual direct medical costs of more than $75 billion, and $82 billion in lost productivity (Centers for Disease Control and Prevention [CDC], 2002). In addition, exposure to environmental tobacco smoke is a preventable cause of significant morbidity and mortality among nonsmokers (USDHHS, 1986). Reducing tobacco-related morbidity and mortality is an ongoing challenge for health care professionals.

Male immigrants in the United States who came from Southeast Asia and Korea have much higher rates of smoking than the general U.S. male population (Baluja, Park, & Myers, 2003; Kim, Ziedonis, & Chen, in press). Estimates of smoking prevalence for Korean American men range from 26.1% to 38.7% (California Health Interview Survey, 2005; Hofstetter et al., 2004; Juon, Kim, Han, Ryu, & Han, 2003) compared with 23.4% for the general adult male population in the United States (CDC, 2005). Little is known about withdrawal symptoms associated with attempts at quitting smoking in this population due to the unavailability of a reliable and valid measure. Therefore, the purpose of this study was to assess the psychometric properties of a Korean translation of the Minnesota Tobacco Withdrawal Scale (MTWS).


Smokers tend to regulate their daily intake of nicotine from cigarettes in order to maintain the desired level (Benowitz, 1999). Pharmacologically, nicotine is as addictive as heroin and cocaine (Henningfield, Cohen, & Slade, 1991). Thus, observations and studies of nicotine withdrawal (Shiffman & Jarvik, 1976; Weybrew & Stark, 1967) predate the development of smoking cessation treatments including nicotine replacement therapy. Shiffman, West, Gilbert, and the SRNT Work Group on the Assessment of Craving and Withdrawal in Clinical Trials (2004) defined withdrawal "as a syndrome of behavioral, affective, cognitive, and physiological symptoms, typically transient, emerging upon cessation or reduction of tobacco use and causing distress or impairment" (p. …

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