Comparison of Exhaled Carbon Monoxide and Fagerstrom Test for Nicotine Dependency in Non-Cigarette Nicotine Addicts

Introduction/Aim: Fagerstrom test for Nicotine Dependency (FNDT) is one of the most frequent tools used to assess the nicotine dependency in primary care. Today, apart from classical cigarette smoking many nicotine addicts may prefer other methods (e-cigarette, hookah, pipe, cigars, light cigarette users or directly tobacco users) to gather nicotine. The main aim of this study is to evaluate the effectiveness of FNDT in this non-classical nicotine addicts. Material and Methods: Among 550 volunteered patients who have administered to the OMU Family Medicine Departments smoking cessation clinic in 2019 have been divided into two groups (Study and control). The study group consisted of 62 (11.2%) nicotine addicts who don’t smoke cigarette (Non-classical) and 488 (88.8%) cigarette smoker (classical) nicotine addict. Both groups’ FNDT scores, their package year scores are calculated and their exhaled CO (E-CO) is measured. Then these results have been analyzed. Results: Among all of the subjects 388 were men (70.5%). The mean age of the participants was 39,31±12,84 years. Although there is no difference between the E-CO measurements between two groups (p>0,05), there was statistically difference between the mean scores of package/year and FNDT scores between the two groups (t=1.258, t=2.014, p<0.001 respectively). There was a strong correlation between FNDT (r=0,468) and package/year (r=0,362) with E-CO in control group (p<0,001) while there was no statistical significance between FNDT (r=0.114) and package/ year (r=0.098) in study group (p=0.06). There was a statistically significant relation between E-CO with FNDT and package/year was observed in cigarette smokers (Control Group) (F=35.305, p<0.001). Conclusion: Although FNDT is a very effective tool for assessing nicotine dependency for classical smokers, it may be not suited for all of the nicotine addicts. It may be useful to design and search new assessment methods for nicotine dependence in non-conventional smokers in primary care.