Development and psychometric evaluation of the smoking attitude scale in adolescents

Abstract

Objectives: Smoking addiction poses a major public health risk, with its onset frequently occurring during adolescence. Attitudes toward smoking significantly influence the development of smoking addiction, making the assessment of these attitudes essential for effective prevention and intervention strategies. This study aimed to develop a scale for assessing adolescents' attitudes toward smoking and to evaluate its psychometric properties. Study design: This study employs a methodological framework for developing and validating a measurement scale. Methods: The study was conducted among 10th and 11th-grade students at high schools. Data were collected from 602 high school students between February 19 and February 29, 2024. The students' mean age was 15.83 +/- 0.74 years, with 58.8 % (n = 354) being female and 41.2 % (n = 248) male. The proportion of students who smoked was 11 % (n = 66). Among non-smokers, 36.4 % (n = 195) had attempted smoking. The mean age at which smokers began smoking was 14 +/- 1.50 years. The selection of candidate items was based on a comprehensive literature review and focus group discussions with adolescents. The factor structure of the scale was analyzed using exploratory and confirmatory factor analyses across different sample groups. Convergent and discriminant validity were examined, and reliability was assessed through Cronbach's alpha coefficients, corrected item-total correlations, and test-retest analysis. Results: Exploratory factor analysis revealed that the Smoking Attitude Scale consists of three factors comprising 15 items, which focus on health risks, social influences, and peer pressure, accounting for 62.50 % of the total variance. Confirmatory factor analysis supported this structure. Both convergent and discriminant validity were established. The scale demonstrated high reliability, with an overall Cronbach's alpha value of 0.90, and factor values of 0.88, 0.78, and 0.84. Composite reliability scores for the factors were 0.88, 0.81, and 0.83, respectively. Conclusions: The Smoking Attitude Scale is a valid and reliable instrument for evaluating adolescents' attitudes toward smoking.