The Psychometric Properties of the Minnesota Tobacco Withdrawal Scale Among Patients With Mental Illness

Yazan D. Al-Mrayat, Chizimuzo T.C. Okoli, Christina R. Studts, Mary K. Rayens, Ellen J. Hahn

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background and Objectives: Approximately 65% of psychiatric inpatients experience moderate-to-severe nicotine withdrawal (NW), a set of symptoms appearing within 24 hr after an abrupt cessation or reduction of use of tobacco-containing products in those using nicotine daily for at least a couple of weeks. The Minnesota Tobacco Withdrawal Scale (MTWS) is a widely used instrument for detecting NW. However, the psychometric properties of the MTWS have not previously been examined among patients with serious mental illness (SMI) undergoing tobacco-free hospitalization. The objective of this study was to examine the validity and reliability of the MTWS among patients with SMI during tobacco-free psychiatric hospitalization. Methods: Reliability was tested by examining Cronbach’s α and item analysis. Validity was examined through hypothesis testing and exploratory factor analysis (N = 255). Results: The reliability analysis yielded a Cronbach’s α coefficient of.763, an inter-item correlations coefficient of.393, and item-total correlations between.291 and.691. Hypothesis testing confirmed the construct validity of the MTWS, and an exploratory factor analysis yielded a unidimensional scale. Conclusion: The MTWS demonstrated adequate reliable and valid psychometric properties for measuring NW among patients with SMI. Nurses and other health-care professionals may use this instrument in clinical practice to identify patients with SMI experiencing NW. The MTWS is psychometrically sound for capturing NW during tobacco-free psychiatric hospitalization. Future research should examine the efficacy of the MTWS in measuring NW in this population over an extended period of hospitalization.

Original languageEnglish
Pages (from-to)247-255
Number of pages9
JournalBiological Research for Nursing
Issue number2
StatePublished - Apr 1 2020


  • mental illness
  • nicotine withdrawal
  • psychometric properties
  • tobacco

ASJC Scopus subject areas

  • Research and Theory


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