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

OBJECTIVE 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 (i.e., toxic tobacco residue) related knowledge, attitudes, and behavior (KABs). METHOD Items for the KAB scales were adapted from established secondhand smoke measures, reviewed to support face validity, and tested in a longitudinal online survey evaluating thirdhand smoke health messages. Participants were California adults at risk of thirdhand smoke exposure. For seven 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 (αrange: .87-.90), attitude (αrange: .84-.87), and behavior (αrange: .80-.86). Similarly, analyses supported scale convergent validity (scale correlations rrange: .45-.85; all p-values <.001), discriminant validity between smokers and nonsmokers (knowledge Cohen's drange: .57-.61, all p-values <.001; attitude Cohen's drange: .78-.82, all p-values <.001; behavior Cohen's drange: .90-.99, all p-values <.001), and predictive validity (Range R 2K.AB: .41-.48; all p-values <.001). CONCLUSION KAB scales about thirdhand smoke 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. IMPLICATIONS Numerous scales have been vetted as reliable and valid measures for assessing secondhand smoke-related knowledge, attitudes, and behaviors. Currently, standard measures of thirdhand smoke knowledge, attitudes, and behaviors are not available. This study tested three thirdhand smoke scales to fill this gap. The present findings provide tobacco control advocates, scholars, and practitioners tools for assessing knowledge, attitudes, and behaviors related to thirdhand smoke. This information is critical to development, implementation, and evaluation of novel tobacco control strategies.