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In various studies, question 1 ("How soon after you wake up do you smoke?") has been found to be present in both factors,(12,29) to be part of factor 2,(14,21,23,25) or to remain in factor 1.(7,16,27) Given that factor 2 consists of only two items in some studies, its ability to represent a single factor has been questioned.(7) Validity and correlation of the FTND with other measures of nicotine dependence We identified only one study in which the sensitivity and specificity of the FTND was evaluated.(13) That study, conducted in Japan, involved a sample of patients with cancer and used the Diagnostic and Statistical Manual of Mental Disorders (Revised Third Edition) as the gold standard

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