Thirdhand Smoke Knowledge, Attitudes, and Behavior: Development of Reliable and Valid Self-report Measures

Abstract

Abstract Introduction This study sought to provide essential tobacco control tools by testing the reliability and validity of new self-report scales developed to assess thirdhand smoke (THS) (ie, toxic tobacco residue) related knowledge, attitudes, and behavior (KAB). Aims and Methods Items for the KAB scales were adapted from established secondhand smoke (SHS) measures, reviewed to support face validity, and tested in a longitudinal online survey evaluating THS health messages. Participants were California adults at risk of THS exposure. For 7 months, the three KAB scales were completed monthly, and data from the first (n = 1086), third (n = 315), and seventh (n = 301) month surveys were used in these analyses. Results All three scales demonstrated consistent reliability and single-factor loading at all three timepoints for knowledge (αrange: .87–.90), attitude (αrange: .84–.87), and behavior (αrange: .80–.86). Similarly, analyses supported scale convergent validity (scale correlations rrange: .45–.85; all p values <.001), discriminant validity between smokers and nonsmokers (knowledge Cohen’s drange: .57–.61, all p values <.001; attitude Cohen’s drange: .78–.82, all p values <.001; behavior Cohen’s drange: .90–.99, all p values <.001), and predictive validity (range R2KAB: .41–.48; all p values <.001). Conclusions KAB scales about THS provide new opportunities for tobacco control advocates and scholars to identify gaps in knowledge, misperceptions, and obstacles to behavior change in order to guide the design of novel tobacco control policies and interventions. Implications Numerous scales have been vetted as reliable and valid measures for assessing SHS-related KABs. Currently, standard measures of THS KABs are not available. This study tested three THS scales to fill this gap. The present findings provide tobacco control advocates, scholars, and practitioners tools for assessing KABs related to THS. This information is critical to development, implementation, and evaluation of novel tobacco control strategies.