Abstract

Rates of tobacco use among adolescents in China and other lower and middle-income countries remain high despite notable prevention and intervention programs. One reason for this may be the lack of theory-based research in tobacco use prevention in these countries. In the current study, a culturally appropriate 21-item measurement scale for cigarette smoking was developed based on the core constructs of Protection Motivation Theory (PMT). The scale was assessed among a sample of 553 Chinese vocational high school students. Results from correlational and measurement modeling analysis indicated adequate measurement reliability for the proposed PMT scale structure. The two PMT Pathways and the seven PMT constructs were significantly correlated with adolescent intention to smoke and actual smoking behavior. This study is the first to evaluate a PMT scale for cigarette smoking among Chinese adolescents. The scale provides a potential tool for assessing social cognitive processes underlying tobacco use. This is essential for understanding smoking behavior among Chinese youth and to support more effective tobacco use prevention efforts. Additional studies are needed to assess its utility for use with Chinese youth in other settings.

Highlights

  • This study details the development and evaluation of a measurement scale for cigarette smoking behavior among adolescents in China based on the constructs of Protection Motivation Theory (PMT) [1]

  • Results (Table 3) indicate that the seven PMT constructs individually and in groups, as well as the Threat Appraisal Pathway and the Coping Appraisal Pathway were each significantly correlated with intentions to smoke and the number of cigarettes smoked per day for the total sample and the subsamples of boys and girls, with a few exceptions

  • We developed and assessed a measurement scale for adolescent tobacco research in China based on Protection Motivation Theory [1,2,3,4,6]

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Summary

Introduction

This study details the development and evaluation of a measurement scale for cigarette smoking behavior among adolescents in China based on the constructs of Protection Motivation Theory (PMT) [1]. The central tenet of the theory is that people protect themselves based on their perceptions of four factors: the severity of a threatening event, the probability of the occurrence of threat, the efficacy of the recommended preventive behavior, and self-efficacy to adapt the recommended behavior [1]. PMT includes both threat and coping appraisals, making it useful to explain why people engage in unhealthy behaviors, such as smoking, despite the wellknown health risks. In the current form, as shown, PMT consists of two highly correlated pathways: 1) Threat Appraisal, assessing the maladaptive behaviors (e.g. behaviors that lead an individual toward a health risk behaviors and/or to noxious consequences) and, 2) Coping Appraisal, assessing the ability to manage and avoid the threatened danger described by Threat Appraisal. Perception of a greater threat will decrease the probability of selecting and engaging in a maladaptive behavior, whereas perception of a greater reward will increase the probability of selecting a maladaptive behavior

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