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

Area of Science:

• Public Health
• Tobacco Control Research
• Health Behavior Measurement

Background:

• Thirdhand smoke (THS) exposure poses health risks, yet standardized measures for assessing related knowledge, attitudes, and behavior (KAB) are lacking.
• Existing secondhand smoke (SHS) measures provide a foundation for developing new assessment tools.
• This study addresses the need for validated instruments to evaluate THS-specific KAB.

Purpose of the Study:

• To test the reliability and validity of newly developed self-report scales for assessing THS-related KAB.
• To provide essential tobacco control tools for researchers and practitioners.
• To inform the development of targeted interventions and policies for THS.

Main Methods:

• Adapted items from established SHS KAB scales.
• Conducted a 7-month longitudinal online survey with California adults at risk of THS exposure.
• Analyzed data from the first, third, and seventh monthly surveys (N=1086, 315, 301) to assess scale properties.

Main Results:

• All three KAB scales demonstrated consistent reliability (Cronbach's α range: .80-.90) and single-factor structure across timepoints.
• Analyses supported convergent validity (r range: .45-.85), discriminant validity between smokers and nonsmokers (Cohen's d range: .57-.99), and predictive validity (R² range: .41-.48).
• All validity and reliability metrics were statistically significant (p < .001).

Conclusions:

• The validated KAB scales for THS offer a crucial tool for tobacco control advocates and researchers.
• These scales enable the identification of knowledge gaps, misperceptions, and behavioral barriers related to THS.
• Findings support the design of novel tobacco control policies and interventions to mitigate THS risks.