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Original Article
Comparison of Social Nicotine Dependence Using the KTSND-K Questionnaire between patients with lung cancer and non-cancer people
Jin Young Lee1, Chul Ho Oak1, Tae Won Jang1, Maan Hong Jung1, Seong Jin Nam1, Su Kyung Son2, Ji Hyun Lee2, Eun Joo Jo2, Sang Joon Lee3
Kosin Medical Journal 2015;30(1):51-58.
DOI: https://doi.org/10.7180/kmj.2015.30.1.51
Published online: January 20, 2015

1Department of Internal Medicine, College of Medicine, Kosin University, Gospel Hospital, Busan, Korea

2College of Nursing science, Kosin University, Busan, Korea

3Department of Ophthalmology, College of Medicine, Kosin University, Gospel Hospital, Busan, Korea

Corresponding Author:Chul Ho Oak, Department of Internal Medicine, College of Medicine, Kosin University, Gospel Hospital, 262, Gamcheon-ro, Seo-gu, Busan, Korea TEL: +82-51-990-6215 FAX: +82-51-248-5686 E-mail: oaks70@dreamwiz.com
• Received: November 14, 2013   • Accepted: June 30, 2014

Copyright © 2015 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    Smoking is one of the most important leading causes of lung cancer. Smoking habit is recognized as nicotine dependence, which consists of physical and psychosocial dependence. To evaluate social nicotine dependence, the Kano Test for Social Nicotine Dependence (KTSND) working group developed a new questionnaire. We examined the social nicotine dependence among high school students, university students and patients with lung cancer.
  • Method
    We applied Korean version of KTSND(KTSND-K) questionnaire to high school students, university students and patients with lung cancer. Complete data obtained from the 1333 responders were analyzed.
  • Results
    Among the responders, current smokers, past-smokers, and never-smokers were 17.3%, 16.4%, and 66.3% respectively. According to smoking status, the total KTSND-K scores of current smokers were significantly higher than those of past-smokers, and of never-smokers (17.7±6.6 versus 13.7±5.7, and 10.9±5.15, P<0.001). The total KTSND-K scores of males were higher than those of females, suggesting that males have a propensity for depending nicotine socially much more than females (13.2±6.2 and 11.7±5.7 respectively, P<0.05). And the total KTSND scores of the patients with lung cancer, medical students, nursing students, and high school students were 11.2±3.8, 14.9±4.8, 14.6±5.8 and 15.6±5.9 respectively. The scores of patients with lung cancer were significantly lower than non-cancer people(P<0.01). Our study suggested that the KTSND-K questionnaire could be a useful method to evaluate psychosocial aspects of smoking in patients with lung cancer and non-cancer people.
Table 1.
KTSND(The Kano Test for Social Nicotine Dependence)-K version 2
Questions Choices (scores)
Q1 담배를 피우는 것 자체가 병이다. DN(3), PN(2), PY(1), DY§(0)
Smoking itself is a disease.
Q2 흡연에는 문화가 있다. DN(0), PN(1), PY(2), DY(3)
Smoking is a part of culture.
Q3 담배는 기호품이다. DN(0), PN(1), PY(2), DY(3)
Tobacco is one of life's pleasures.
Q4 흡연하는 생활 양식도 존중됨이 옳다. DN(0), PN(1), PY(2), DY(3)
Smoker's lifestyles may be respected.
Q5 흡연으로 인해 인생이 풍부해지는 사람도 있다. DN(0), PN(1), PY(2), DY(3)
Smoking sometimes enriches people's life.
Q6 담배에는 효용(몸이나 정신에 좋은 작용)이 있다. DN(0), PN(1), PY(2), DY(3)
Tobacco has positive physical or mental effects.
Q7 담배는 스트레스를 해소하는 작용이 있다. DN(0), PN(1), PY(2), DY(3)
Tobacco has effects to relieve stress.
Q8 담배는 흡연자의 두뇌 활동을 높인다. DN(0), PN(1), PY(2), DY(3)
Tobacco enhances the function of smokers' brains.
Q9 의사는 담배의 해로움에 대해서 너무 많이 말한다. DN(0), PN(1), PY(2), DY(3)
Doctors exaggerate the ill effects of smoking.
Q10 재떨이가 놓여져 있는 곳은 흡연할 수 있는 장소이다. DN(0), PN(1), PY(2), DY(3)
People can smoke at place where ashtrays are available.

Definitely No

Probably No

Probably Yes

§ Definitely Yes. Numbers in parentheses indicate each score.

Table 2.
Background characteristics of subjects
Total numbers N=1333 %
Smoking status    
Current smoker 230 17.3
Past smoker 219 16.4
Never smoker 884 66.3
Gender    
Male 730 54.8
Female 603 45.2
Age    
10's 474 35.6
20's 626 47.0
30's 9 0.70
40's 12 0.90
50's 50 3.80
60's 162 12.2
Group    
Medical student 329 24.7
Nursing student 351 26.3
High school student 423 31.7
Cancer patient 230 17.3
Age of first smoking    
10's 152 66.1
20's 72 31.3
30's 4 1.70
40's 1 0.40
50's 1 0.40
Duration of smoking(years)    
≤10 158 68.7
10–20 13 5.70
20–30 10 4.30
30–40 36 15.7
>40 13 5.70
Average dose of smoking a day(ciga rettes)  
≤10 121 52.6
11–20 78 33.9
21–30 23 10.0
≥31 8 3.50
Stages for quitting smoking    
Immotive 62 27.0
Precontemplator 28 12.2
Contemplator 57 24.8
Preparer 83 36.1
Table 3.
Smoking rate according to gender and seperated groups
  Current Smoker Past smoker Never smoker P-value
Gender       <0.001
Male (730) 170(23.3%) 181(24.8%) 379(51.9%)  
Female (603) 60(10.0%) 38(6.3%) 505(83.7%)  
Group       <0.05
Medical students (329) 45(13.7%) 38(11.6%) 246(74.8%)  
Nursing students (351) 11(3.1%) 15(4.3%) 325(92.6%)  
High school students (423) 109(25.8%) 62(14.7%) 252(59.6%)  
Lung cancer patients (230) 65(28.3%) 104(45.2%) 61(26.5%)  
Table 4.
The total KTSND-K scores according to gender, smoking status and the stages for quitting smoking
  Total scores (mean±SD) P-value
Gender   <0.001
Male 13.2±6.2  
Female 11.7±5.7  
Smoking   <0.001
Current Smoker(n=230) 17.7±6.6  
Past-smoker(n=219) 13.7±5.7  
Never-smoker (n=884) 10.9±5.1  
Stages for quitting smoking   <0.001
Immotive (n=62) 21.6±5.6  
Precontemplator (n=28) 20.6±4.8  
Contemplator (n=57) 18.8±4.6  
Prepare (n=83) 13.1±6.2  
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    • Assessment of physiological and psychological dependence of tobacco use among patients visiting the tobacco cessation center in the tertiary institute of Shimla–Himachal Pradesh
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      Santosh University Journal of Health Sciences.2023; 9(2): 175.     CrossRef

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