Cross-cultural adaptation and validation of a Moroccan Arabic version of the Hooked on Nicotine Checklist

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Background: Early identification of nicotine dependence symptoms is essential for tobacco control and prevention strategies. The Hooked On Nicotine Checklist (HONC) is widely used to assess early symptoms of nicotine dependence. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of a Moroccan Arabic version of the HONC. Methods: A cross sectional study was conducted among a sample of 234 Moroccan smokers. The HONC was translated and adapted following established guidelines. Descriptive statistics and item-total correlations were examined. Internal consistency was assessed using Cronbach's alpha and McDonald's omega. Dimensionality was evaluated using confirmatory factor analysis (CFA) with the WLSMV estimator. IRT analyses were conducted using a two-parameter logistic (2PL) model. Assumptions of unidimensionality, monotonicity, and local independence were systematically tested. Item discrimination and difficulty parameters, item characteristic curves, and test information functions were estimated. Results: /df = 1.34; CFI = 0.998; TLI = 0.998; RMSEA = 0.038; SRMR = 0.059), with substantial standardized loadings (0.629-0.952). Monotonicity and local independence assumptions were fulfilled. Discrimination parameters were generally high (a = 1.40-4.69) and difficulties were mostly negative (b ≈ -0.64 to 0.00), suggesting that the scale is most informative at lower to moderate levels of nicotine dependence. Conclusion: The Moroccan Arabic HONC is a reliable and valid measure of early nicotine dependence. It can be confidently used for research, screening, and tobacco control interventions.

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