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

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 (alpha(range): .87-.90), attitude (alpha(range): .84-.87), and behavior (alpha(range): .80-.86). Similarly, analyses supported scale convergent validity (scale correlations r range:.45-.85; all p values <.001), discriminant validity between smokers and nonsmokers (knowledge Cohen's d(range): .57-.61, all p values <.001; attitude Cohen's d(range):.78-.82, all p values <.001; behavior Cohen's d(range): .90-.99, all p values <.001), and predictive validity (range R-KAB(2) :.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.

Automated summary

This study tested the reliability and validity of new self-report scales for assessing knowledge, attitudes, and behavior related to thirdhand smoke. The results showed consistent reliability and validity of the scales at different time points, supporting their use in identifying gaps in knowledge and guiding the design of novel tobacco control policies and interventions.