Fagerstrom Test: A Tool for Assessing Risk of Subclinical Cardiovascular Disease in Nicotine Users

Gallusena Erickatulistiawan *

Cardiovascular Department, Faculty of Medicine, Brawijaya University – Saiful Anwar Hospital, Malang, Indonesia.

Cholid Tri T

Cardiovascular Department, Faculty of Medicine, Brawijaya University – Saiful Anwar Hospital, Malang, Indonesia.

*Author to whom correspondence should be addressed.


Abstract

The research paper titled "Fagerstrom Test: Evaluating Subclinical Cardiovascular Risk in Nicotine Dependents" delves into the association between nicotine addiction and the likelihood of developing subclinical cardiovascular issues. This investigation utilizes the Fagerstrom Test for Nicotine Dependence (FTND), a widely recognized tool for gauging the severity of nicotine addiction, where higher scores reflect more intense dependency. Given the significant public health issue posed by cardiovascular disease and the known risks associated with smoking, the review critically examines existing studies on how nicotine affects cardiovascular health, the predictive capacity of the Fagerstrom score for cardiovascular events, and the broader consequences for those who use nicotine and their healthcare providers. A pivotal finding of this review is the potential link between nicotine dependency, as determined by the FTND, and an elevated risk of subclinical cardiovascular diseases. However, it's noted that nicotine may not be the only factor contributing to cardiovascular harm, as other elements in traditional cigarettes could also be influential. The study underscores the necessity of considering nicotine dependence in cardiovascular risk assessments for smokers and stresses the urgency for more comprehensive research to fully grasp the connection between nicotine addiction and cardiovascular health.

Keywords: Fagestrom test, subclinical cardiovascular disease


How to Cite

Erickatulistiawan, Gallusena, and Cholid Tri T. 2024. “Fagerstrom Test: A Tool for Assessing Risk of Subclinical Cardiovascular Disease in Nicotine Users”. Asian Journal of Cardiology Research 7 (1):58-63. https://journalajcr.com/index.php/AJCR/article/view/201.


References

Kuller LH, Shemanski L, Psaty BM, Borhani NO, Gardin J, Haan MN et al. Subclinical Disease as an Independent Risk Factor for Cardiovascular Disease. Circulation [Internet]. 1995;92(4):720–6. Available from: https://www.ahajournals.org/doi/abs/10.1161/01.CIR.92.4.720

Singh SS, Pilkerton CS, Shrader CDJ, Frisbee SJ. Subclinical atherosclerosis, cardiovascular health, and disease risk: is there a case for the Cardiovascular Health Index in the primary prevention population? BMC Public Health. 2018 Apr;18(1):429.

Benowitz NL, Burbank AD. Cardiovascular toxicity of nicotine: Implications for electronic cigarette use. Trends Cardiovasc Med. 2016 Aug;26(6):515–23.

Rahman AU, Mohamed MHN, Jamshed S, Mahmood S, Iftikhar Baig MA. The Development and Assessment of Modified Fagerstrom Test for Nicotine Dependence Scale among Malaysian Single Electronic Cigarette Users. J Pharm Bioallied Sci. 2020 Nov;12(Suppl 2):S671–5.

Korte KJ, Capron DW, Zvolensky M, Schmidt NB. The Fagerström test for nicotine dependence: Do revisions in the item scoring enhance the psychometric properties? Addict Behav. 2013 Mar;38(3):1757–63.

Hasegawa K, Komiyama M, Takahashi Y. Obesity and cardiovascular risk after quitting smoking: The latest evidence. Eur Cardiol. 2019 Apr;14(1):60–1.

Ikonomidis I, Thymis J, Kourea K, Kostelli G, Neocleous A, Katogiannis K et al. Fagerstrom score predicts smoking status six months after hospitalization for acute myocardial infarction: A prospective study. Hell J Cardiol [Internet]. 2022;67:28–35. Available:https://www.sciencedirect.com/science/article/pii/S1109966622000690

Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The fagerström test for nicotine dependence: A revision of the fagerström tolerance questionnaire. Br J Addict. 1991 Sep;86(9):1119–27.

Lim KH, The CH, Lim HL, Khoo YY, Lau KJ, Yy C et al. Reliability and validity of the fagerstrom test for cigarettes dependence among malaysian adolescents. Iran J Public Health. 2016 Jan;45(1):104–5.

Sharma MK, Suman LN, Srivastava K, Suma N, Vishwakarma A. Psychometric properties of fagerstrom test of nicotine dependence: A systematic review. Ind Psychiatry J. 2021;30(2):207–16.

Pérez-Ríos M, Santiago-Pérez MI, Alonso B, Malvar A, Hervada X, de Leon J. Fagerstrom test for nicotine dependence vs heavy smoking index in a general population survey. BMC Public Health [Internet]. 2009;9(1):493. Available from: https://doi.org/10.1186/1471-2458-9-493

Jaimie Guerra. No Title [Internet]. 2020 [cited 2023 Dec 14]. Available from: https://www.who.int/news/item/22-09-2020-tobacco-responsible-for-20-of-deaths-from-coronary-heart-disease

Conklin DJ, Schick S, Blaha MJ, Carll A, DeFilippis A, Ganz P et al. Cardiovascular injury induced by tobacco products: assessment of risk factors and biomarkers of harm. A Tobacco Centers of Regulatory Science compilation. Am J Physiol Heart Circ Physiol. 2019 Apr;316(4):H801–27.

Hartiala JA, Hilser JR, Biswas S, Lusis AJ, Allayee H. Gene-environment interactions for cardiovascular disease. Current atherosclerosis reports. 2021 Dec;23: 1-9.

Al Rifai M, DeFilippis AP, McEvoy JW, Hall ME, Acien AN, Jones MR et al. The relationship between smoking intensity and subclinical cardiovascular injury: The Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis. 2017;258: 119–30.

Rader F, Rashid M, Nguyen TT, Luong E, Kim A, Kim E, et al. E-Cigarette Use and Subclinical Cardiac Effects. Vol. 127, Circulation research. United States; 2020;1566–7.

de Faria GB, Berger S. Preventive cardiology: A Companion to Braunwald’s. Vol. 47. Pediatric Annals. 2018;477–478.

Mallaina P, Lionis C, Rol H, Imperiali R, Burgess A, Nixon M et al. Smoking cessation and the risk of cardiovascular disease outcomes predicted from established risk scores: Results of the cardiovascular risk assessment among smokers in primary care in Europe (CV-ASPIRE) study. BMC Public Health. 2013 Apr;13:362.

Khazaal MS, Hamdan FB, Al-Mayah QS. Nicotine dependence and visceral adiposity as risk factors for the development and severity of carotid artery stenosis. J Med Life. 2023 Mar;16(3):463–70.

Mallin R. Smoking cessation: Integration of behavioral and drug therapies. Am Fam Physician. 2002 Mar;65(6):1107–14.

Bozkurt N, Uzun SU, Bozkurt AI, Turgut S. Does cardiovascular disease risk decrease after smoking cessation in occupational risk groups? Heart Views. 2022;23(4): 208–14.