Assessing college students' autonomy over smoking with the Hooked On Nicotine Checklist

UMMS Affiliation

Department of Family Medicine and Community Health

Publication Date


Document Type



Adult; Female; Humans; Male; *Personal Autonomy; Psychometrics; Reproducibility of Results; Smoking; *Students; Tobacco Use Disorder; *Universities


Community Health and Preventive Medicine | Preventive Medicine | Psychiatry and Psychology | Psychology | Substance Abuse and Addiction


OBJECTIVE, PARTICIPANTS, AND METHODS: In this study, the authors explored the psychometric properties of the Hooked on Nicotine Checklist (HONC) among 300 college students who were current smokers. The HONC is a 10-item survey instrument designed to measure diminished autonomy over smoking, a key aspect of dependence. Autonomy is diminished when symptoms present a barrier to cessation.

RESULTS: Internal consistency was high (alpha = .89), as was concurrent validity. Students who began smoking earlier and heavier smokers reported more symptoms than did those who started later and smoked less. After controlling for smoking frequency, the HONC was predictive of the likelihood of a failed cessation attempt, with each additional symptom doubling that likelihood.

CONCLUSIONS: College health professionals could use the HONC to help new smokers recognize their symptoms of diminished autonomy. The HONC may serve as a recruiting tool for cessation programs, which could benefit such early-phase smokers.


college students, Hooked on Nicotine Checklist, smoking, smoking cessation, tobacco use disorder

DOI of Published Version



J Am Coll Health. 2008 Mar-Apr;56(5):549-53. doi: 10.3200/JACH.56.5.549-554. Link to article on publisher's site

Journal/Book/Conference Title

Journal of American college health : J of ACH

Related Resources

Link to Article in PubMed