Validation of the alcohol smoking and substance involvement screening test (ASSIST)
Abstract
Aim The concurrent, construct and discriminative validity of the World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were examined in a multi‐site international study. Participants One thousand and 47 participants, recruited from drug treatment ( n = 350) and primary health care (PHC) settings ( n = 697), were administered a battery of instruments. Measurements Measures included the ASSIST; the Addiction Severity Index‐Lite (ASI‐Lite); the Severity of Dependence Scale (SDS); the MINI International Neuropsychiatric Interview (MINI‐Plus); the Rating of Injection Site Condition (RISC); the Drug Abuse Screening Test (DAST); the Alcohol Use Disorders Identification Test (AUDIT); the Revised Fagerstrom Tolerance Questionnaire (RTQ); and the Maudsley Addiction Profile (MAP). Findings Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the ASI‐Lite ( r = 0.76–0.88), SDS ( r = 0.59), AUDIT ( r = 0.82) and RTQ ( r = 0.78); and significantly greater ASSIST scores for those with MINI‐Plus diagnoses of abuse or dependence ( P < 0.001). Construct validity was established by significant correlations between ASSIST scores and measures of risk factors for the development of drug and alcohol problems ( r = 0.48–0.76). Discriminative validity was established by the capacity of the ASSIST to discriminate between substance use, abuse and dependence. Receiver operating characteristic (ROC) analysis was used to establish cut‐off scores with suitable specificities (50–96%) and sensitivities (54–97%) for most substances. Conclusions The findings demonstrated that the ASSIST is a valid screening test for identifying psychoactive substance use in individuals who use a number of substances and have varying degrees of substance use.
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The ASSIST showed strong internal consistency across the drugs it assessed (0.77-0.94) and acceptable correlations with risk-factor measures for alcohol and drug problems (0.48-0.76).
“The ASSIST has high internal consistency across drugs examined (0.77–0.94) and acceptable correlations between ASSIST scores and measures of risk factors for alcohol and drug use problems (0.48–0.76) (Humeniuk et al., 2008).”
From A randomized study of the use of screening, brief intervention, and referral to treatment (SBIRT) for drug and alcohol use with jail inmates (2017) · cites this paper as Humeniuk et al., 2008
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“Findings Concurrent validity was demonstrated by significant correlations between ASSIST scores and scores from the ASI-Lite (r = 0.76–0.88), SDS (r = 0.59), AUDIT (r = 0.82) and RTQ (r = 0.78); and significantly greater ASSIST scores for those with MINI-Plus diagnoses of abuse or dependence (P < 0.001).”
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- Authors
- Humeniuk, R., Ali, R., Babor, T. F., Farrell, M., Formigoni, M. L., Jittiwutikarn, J., De Lacerda, R. B., Ling, W., Marsden, J., Monteiro, M., Nhiwatiwa, S., Pal, H., Poznyak, V., & Simon, S.
- Affiliations
- UConn Health (US)
- Universidade Federal de São Paulo (BR)
- University of California, Los Angeles (US)
- World Health Organization (CH)
- University of Zimbabwe (ZW)
- All India Institute of Medical Sciences (IN)
- Corresponding author
- Humeniuk, Rachel
- ORCID
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2008-03-29
- Volume
- 103
- Issue
- 6
- Pages
- 1039-1047
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W2026746056
- Cited by
- 1,144
- References
- 26
- Citations by year
- 2026: 75 · 2025: 80 · 2024: 96 · 2023: 86 · 2022: 98 · 2021: 97 · 2020: 97 · 2019: 79 · 2018: 50 · 2017: 73 · 2016: 79 · 2015: 65 · 2014: 61 · 2013: 41 · 2012: 27
- FWCI
- 9.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion)
- Funders
- World Health Organization
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- ASSIST, alcohol screening, smoking screening, substance use screening, screening test validation, concurrent validity, construct validity, discriminant validity, substance dependence, substance abuse, primary care, pharmacotherapy, cut-off values, auditing, Fagerström Tolerance Questionnaire
- MeSH terms
- Adult, Cross-Cultural Comparison, Female, Humans, Male, Mass Screening, Middle Aged, Predictive Value of Tests, Primary Health Care, Psychometrics, Severity of Illness Index, World Health Organization, Substance Abuse Detection, Substance Abuse Treatment Centers, Substance-Related Disorders
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