The ABOUT™–Dependence is a Consumer Reported Outcomes Measure (CROM) developed to assess perceived dependence associated with tobacco and/or nicotine product (TNP) use. It was developed and validated in US English for TNP users who were either exclusive or poly users of different TNPs (including cigarettes, e-cigarettes, cigars/cigarillos, smokeless tobacco, pipes, and waterpipes) and nicotine replacement therapy (NRTs). The initial validation confirmed the psychometric performance of a 12-item version of the CROM consisting of three domains: Extent of Use (2 items); Signs and Symptoms (5 items); and Behavioral Impact (5 items).

This presentation will describe additional research conducted to assess the validity of the CROM when applied to heated tobacco products (HTPs) use (specifically, IQOS) and to evaluate its cross-cultural validity. The research included analyses of data collected as part of an online survey with 1320 adult TNP users in the US, Germany, Italy, Russia, and Japan who were cigarette smokers or who had switched from smoking cigarettes to using either HTPs (IQOS) or other TNPs (e.g., e-cigarettes) exclusively or were dual users of cigarettes and another TNP. The presentation will outline the psychometric techniques (Rasch Measurement Theory (RMT) and Classical Test Theory (CTT)) used to confirm the measurement properties of the CROM in an extended frame of reference. The findings largely aligned with the previous validation of the CROM and provided supportive evidence of the CROM’s reliability and validity for the whole sample (N = 1320) and a subset of exclusive IQOS users (N = 263). The instrument’s stability across different countries/languages was also acceptable, although differential item functioning (DIF) by country/language was observed for some items.

Overall, the research further supports the ABOUT™–Dependence as a psychometrically valid measure of perceived dependence with broad cross-cultural applicability to different types of TNPs and product use behaviors.