A comparison of the Autonomy over Tobacco Scale and the Fagerstrom Test for Nicotine Dependence

UMMS Affiliation

Department of Family Medicine and Community Health

Publication Date


Document Type



Tobacco Use Disorder


Community Health and Preventive Medicine | Preventive Medicine | Primary Care


The Autonomy over Tobacco Scale (AUTOS) is a 12-item theory-based instrument used to measure tobacco dependence in smokers. It provides separate measures of three factors that make smoking cessation more difficult: withdrawal symptoms, psychological dependence, and cue-induced urges to use tobacco. We compared the internal reliability and concurrent validity of the AUTOS to those of the Fagerstrom Test for Nicotine Dependence (FTND). Adult current smokers (n=422; 62% female; 86.8% white; mean age 33.3years, SD=13.7; 57% daily smokers) completed an anonymous web-based survey that included the AUTOS, the FTND and 11 smoking-related behavioral measures. Cronbach's alpha was .94 for the AUTOS and alpha>.75 for each of the 3 subscales; alpha=.73 for the FTND. The AUTOS and its subscales correlated with all measures of concurrent validity (r=.70 between AUTOS and FTND). The AUTOS correlated better than the FTND with the Hooked on Nicotine Checklist, the longest period of abstinence, latency to wanting, percentage of time a person smokes because of momentary need, pleasure from smoking, days smoked per month, and concern about deprivation. The measures showed similar correlations with the latencies to craving and needing. The FTND correlated better with the duration of smoking and cigarettes smoked per day. Based on these results and those from prior studies, we conclude that the AUTOS offers researchers a valid and highly reliable, theory-based measure that is more versatile in its applications than the FTND.

DOI of Published Version



Addict Behav. 2012 Mar 17. DOI 10.1016/j.addbeh.2012.03.013

Journal/Book/Conference Title

Addictive behaviors

Related Resources

Link to Article in PubMed