The Modified Reasons for Smoking Scale: Factorial structure, gender effects and relationship with nicotine dependence and smoking cessation in French smokers

Aims: To assess the validity of the French version of the Modified Reasons for Smoking Scale (MRSS), and to identify which smoking patterns differentiate male and female smokers, which are related to tobacco dependence (as assessed by the Fagerström Test for Nicotine Dependence, FTND), to mood (Beck Depression Inventory II), to affect (Positive and Negative Affect Schedule) and which are predictors of successful quitting. Participants: Three hundred and thirty smokers [(mean ±SD) aged 40±9 years, 145 (44%) women, mean FTND score: 6.2±2], candidates for a smoking cessation programme and smoking at least 15 cigarettes/day. Findings: Factor analysis of the 21-item scale gave the optimal fit for a sevenfactor model, which accounted for 62.3% of the total variance. The following factors were identified: 'addictive smoking', 'pleasure from smoking', 'tension reduction/relaxation', 'social smoking', 'stimulation', 'habit/automatism' and 'handling'. The 'addictive smoking' score increased in a dose-dependent manner with number of cigarettes smoked per day: the 'habit/automatism' score was significantly higher, with more than 20 cigarettes per day than with ≤20 cigarettes per day. The reasons for smoking were different for males and females: females scored higher on 'tension reduction/relaxation', 'stimulation' and 'social smoking'. A high level of dependence (FTND≥6) was associated with significantly higher scores only on 'addictive smoking', the association being stronger in females. Time to first cigarette after awakening was associated with higher 'addictive smoking' and 'habit/automatism' (P < 0.001). In a multivariate logistic regression, failed quitting was predicted by higher habit/automatism score (odds ratio = 1.44, 95% CI = 1.06-1.95, P = 0.02) and greater number of cigarettes smoked per day (odds ratio = 1.03, 95% CI = 1.01-1.06, p = 0.03). Conclusions: The questionnaire yielded a coherent factor structure: women smoked more for tension reduction/relaxation, stimulation and for social reasons than men: addictive smoking and automatic smoking behaviour were similar in both sexes and were associated strongly with a high level of nicotine dependence; the 'habit/automatism' score predicted failure to quit over and above cigarettes per day.