CAGE Questionnaire for smoking

 

Advantages:

• free to use

• quick

• relatively non-confrontational

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Disadvantages: 

• ​questions do not discriminate well between active and inactive smokers, so following positive scores on the CAGE with questions regarding usual consumption patterns (e.g., frequency/quantity/heaviest consumption) will help make this distinction

 

Accuracy : (Brown RL, 1995)

CAGE : sensitivity 85.1% and specificity 88.9%

Note :

Examples of actual patient responses to these questions include the following:

Cut down: “I wanted to quit smoking, but I couldn't do it, so I switched to a low-tar cigarette.”

Annoyed: “Last week, my granddaughter said to me, ‘Grandma, I wish you would stop smoking,’ and I snapped at her, ‘Well, I'm old enough to smoke—are you?’”

Guilty: “I should have stopped smoking long ago—my family wouldn't have to suffer on my account like this if I had.”

Eye-opener: “I smoke my first cigarette before my feet hit the floor.”

Experience has shown the CAGE questionnaire to be nonthreatening. In one study, medical outpatients were given the CAGE questions embedded in a self-administered questionnaire about health habits, and most of them did not realize that they were filling out an assessment for addictions.

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Note :

CAGE is not used to diagnose diseases, but only to indicate whether a problem might exist.

The questions are most effective when used as part of a general health history and should NOT be preceded by questions about how much or how frequently the patient smokes or uses drugs.

The reason for this is that denial is very common among smokers and therefore, the CAGE questions focus the discussion toward the behavioral effects of the smoking rather than toward the number of smokes per day

 

However, because questions do not discriminate well between active and inactive drinkers or drug users, FOLLOWING positive scores with questions regarding usual consumption patterns (e.g., frequency/quantity/heaviest consumption) will help make this distinction.

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Note :

By far the most important question in the questionnaires is smoking as an Eye Opener, so much so that some clinicians use a "yes" to this question alone as a positive to the questionnaire.

This is because smoking as an Eye Opener connotes dependence since the patient is going through possible withdrawal in the morning, hence the need for a smoke as an Eye Opener.