Abstract
Background: We conducted a psychometric analysis of an adapted secondhand smoke (SHS) questionnaire by testing the three-component structure of the original scale that measures SHS exposure in home, work and social environments. Methods: The 15-item questionnaire was administered to 839 daily smokers participating in a multi-site randomized controlled trial. Following parallel analysis, we conducted a confirmatory factor analysis specifying a three-factor structure. Cronbach’s alphas and fit indices were calculated to assess internal consistency. Criterion validity was assessed by comparing the Social environments subscale to the Brief Wisconsin Inventory of Smoking Dependence Motives Social/Environmental Goads subscale. Predicative validity of the questionnaire was assessed using linear regressions and tobacco biomarkers of harm; NNAL, expired carbon monoxide and total cotinine. Results: Five items did not load onto any factor and were dropped, resulting in a 10-item questionnaire. The Cronbach’s alphas were (0.86), (0.77) and (0.67) for the Work, Social, and Home subscales, respectively. The WISDM subscale was moderately correlated with scores on the Social subscale (r = 0.57, p < 0.001). The questionnaire demonstrated predictive validity of smoke exposure above individual’s own reported use as measured by cigarettes smoked per day. Conclusions: Three constructs emerged; results indicate that a shortened 10-item scale could be used in future studies.
Highlights
Introduction iationsVoluntary and involuntary exposure to tobacco smoke is a known health hazard and preventable cause of death [1,2]
Study participants were non-treatmentseeking daily smokers who were willing to use research cigarettes varying in nicotine content for a 6-week period
Item 9 assesses whether the respondent permits smoking in their car, which is relevant to social exposure, but did not load onto any factor
Summary
Voluntary and involuntary exposure to tobacco smoke is a known health hazard and preventable cause of death [1,2]. Sources of exposure to involuntary smoke, otherwise known as secondhand smoke (SHS), include smoke coming directly from a burning tobacco product (sidestream smoke) and smoke exhaled by a smoker (mainstream smoke) [3,4,5]. SHS contains thousands of chemicals, including hundreds known to be toxic or carcinogenic [5]. The term SHS exposure has largely replaced environmental tobacco smoke (ETS) exposure in the literature as it indicates the involuntary nature of the exposure, whereas use of the term environmental has a more ambient connotation [5]
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