Assessing the reliability and validity of anti-tobacco attitudes/beliefs in the context of a campaign strategy

Prev Med. 2004 Nov;39(5):909-18. doi: 10.1016/j.ypmed.2004.03.028.


Objectives: To identify multi-item attitude/belief scales associated with the theoretical foundations of an anti-tobacco counter-marketing campaign and assess their reliability and validity.

Methods: The data analyzed are from two state-wide, random, cross-sectional telephone surveys [n(S1)=1,079, n(S2)=1,150]. Items forming attitude/belief scales are identified using factor analysis. Reliability is assessed with Chronbach's alpha. Relationships among scales are explored using Pearson correlation. Validity is assessed by testing associations derived from the Centers for Disease Control and Prevention's (CDC) logic model for tobacco control program development and evaluation linking media exposure to attitudes/beliefs, and attitudes/beliefs to smoking-related behaviors. Adjusted odds ratios are employed for these analyses.

Results: Three factors emerged: traditional attitudes/beliefs about tobacco and tobacco use, tobacco industry manipulation and anti-tobacco empowerment. Reliability coefficients are in the range of 0.70 and vary little between age groups. The factors are correlated with one-another as hypothesized. Associations between media exposure and the attitude/belief scales and between these scales and behaviors are consistent with the CDC logic model.

Conclusions: Using reliable, valid multi-item scales is theoretically and methodologically more sound than employing single-item measures of attitudes/beliefs. Methodological, theoretical and practical implications are discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Advertising / statistics & numerical data
  • Child
  • Cross-Sectional Studies
  • Female
  • Health Education / methods*
  • Health Education / statistics & numerical data*
  • Health Knowledge, Attitudes, Practice*
  • Health Surveys
  • Humans
  • Male
  • Odds Ratio
  • Program Development / methods*
  • Program Evaluation
  • Reproducibility of Results
  • Tobacco Use Disorder / prevention & control*
  • United States