Short Michigan Alcoholism Screening Test (SMAST)
Screens for alcohol abuse.
- Studies have used various cutoffs to indicate a positive screening test, with a wide variety of sensitivity and specificity.
- Ensure you know the standard of care in your practice.
- Shorter than the 25-item Michigan Alcoholism Screening Test, while retaining its validity.
ADVICE
Patients with heavy alcohol use should also be screened for other illicit drug use.FORMULA
| 0 Points | 1 Points | |
|---|---|---|
| Patient feels they are a normal drinker. That they drink less than or the same amount as most people | Yes | No |
| Spouse or other near relative has worried or complained about patient’s drinking | No | Yes |
| Patient has ever felt guilty about drinking | No | Yes |
| Friends/relatives think patient is a normal drinker | Yes | No |
| Patient is able to stop drinking when they want | Yes | No |
| Patient has ever attended an Alcoholics Anonymous meeting | No | Yes |
| Drinking has ever created problems with spouse or other near relative | No | Yes |
| Patient has gotten into trouble at work because of drinking | No | Yes |
| Patient has neglected family, obligations, or work for ≥2 days in a row because of drinking | No | Yes |
| Patient has ever sought help for drinking | No | Yes |
| Patient has ever been in a hospital because of drinking | No | Yes |
| Patient has ever been arrested for driving while intoxicated | No | Yes |
| Patient has ever been arrested for other drunken behavior. Even if only a few hours | No | Yes |
Facts & Figures
| SMAST Score | Interpretation | Recommendation |
|---|---|---|
| 0–2 | Low risk, no apparent problem | Repeat screening as needed |
| 3 | Borderline risk, potential early alcohol problem | Consider further investigation |
| ≥4 | High risk, likely alcohol abuse | Full assessment recommended |
Literature
ORIGINAL/PRIMARY REFERENCE
Selzer ML, Vinokur A, Van rooijen L. A self-administered Short Michigan Alcoholism Screening Test (SMAST). J Stud Alcohol. 1975;36(1):117-26.
VALIDATION
Shields AL, Howell RT, Potter JS, Weiss RD. The Michigan Alcoholism Screening Test and its shortened form: a meta-analytic inquiry into score reliability. Subst Use Misuse. 2007;42(11):1783-800.
Robin RW, Saremi A, Albaugh B, Hanson RL, Williams D, Goldman D. Validity of the SMAST in two American Indian tribal populations. Subst Use Misuse. 2004;39(4):601-24.
Nanakorn S, Fukuda K, Ogimoto I, Tangseree T, Treethiptikhun S. Validation of the Short Michigan Alcoholism Screening Test Thai version in northeastern Thailand. Southeast Asian J Trop Med Public Health. 2000;31(4):780-6.
Harburg E, Gunn R, Gleiberman L, Roeper P, Difranceisco W, Caplan R. Using the Short Michigan Alcoholism Screening Test to study social drinkers: Tecumseh, Michigan. J Stud Alcohol. 1988;49(6):522-31.
OTHER REFERENCES
Selzer ML. The Michigan alcoholism screening test: the quest for a new diagnostic instrument. Am J Psychiatry. 1971;127(12):1653-8.
Zung BJ. Reliability and validity of the short mast among psychiatric inpatients. J Clin Psychol. 1984;40(1):347-50.
