Agreement and classification performance of the heaviness of smoking index (HSI) compared with the Fagerström test for cigarette dependence (FTCD): A subgroup analysis.

Abdurrahman Charkazi, Seyed Ghadir Hosseini, Hajar Dehghan, Arezou Foroughi, Bagher Pahlavanzadeh

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Article in Addictive behaviors reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Abdurrahman CharkaziAssociate Professor of Health Education & Promotion, Environmental Health Research Center, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran.

Seyed Ghadir HosseiniAssistant Professor of Health Education and Promotion, Department of Public Health, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran.

Hajar DehghanDepartment of Nursing, Gonbad Kavous School of Nursing, Golestan University of Medical Sciences, Gonbad Kavous, Iran.

Arezou ForoughiHealth Care, Education Organization, Gonbad Kavous County, Gonbad Kavous, Iran.

Bagher PahlavanzadehAssistant Professor of Biostatistics, Research Center for Environmental Contaminants (RCEC), Abadan University of Medical Sciences, Abadan, Iran.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The Heaviness of Smoking Index (HSI) is a brief tool for assessing nicotine addiction. This study evaluated the agreement and classification performance of the HSI relative to the Fagerström Test for Cigarette Dependence (FTCD). Methods: In this cross-sectional study of 1147 adult smokers, HSI scores were derived from the FTCD. Agreement and apparent classification performance were examined using Pearson correlation, intraclass correlation coefficient (ICC), Cohen's kappa, receiver operating characteristic (ROC) analysis, and Bland-Altman plots across demographic and behavioral subgroups. Results: HSI showed a strong correlation with FTCD ( Conclusion: HSI demonstrates strong agreement with FTCD and may serve as a rapid screening measure for assessing nicotine addiction. A lower cut-off (≥3) may be useful for initial screening, whereas a higher cut-off (≥4) may help identify severe addiction. Caution is warranted at higher addiction levels and among poly-tobacco users.

Indexed as

Cigarette smokingFTCDHSINicotine addictionROC analysis

Identifiers

PMID42699524

DOI10.1016/j.abrep.2026.100740

PMCPMC13543796

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.