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National Cancer Institute
Behavioral Research - Cancer Control and Population Sciences

NCI Measures Guide for Youth Tobacco Research

Adolescent Smoking Consequences Questionnaire
Hanson et al

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Brief Description: The FAHQ is based on the theory of planned behavior (Ajzen, 1985) and includes questions that measure the belief-based measures of attitude, subjective norm, and perceived behavioral control (i.e., self-efficacy). This measure includes a total of 40 items rated on 7-point Likert scales. 24 items focus on attitudes toward smoking, 10 items on subjective norms regarding smoking, and 6 items on perceived behavioral control.

The Smoking Attitudes Scale contains 12 behavioral belief statements with response choices ranging from "likely" to "unlikely", and 12 corresponding outcome evaluation statements with response choices ranging from "bad" to "good".
The Subjective Norms Scale consists of five referent statements with response choices ranging from "approve" to "disapprove", and five corresponding motivation to comply statements with response choices ranging from "agree" to "disagree".
The Perceived Behavioral Control Scale consists of three control items related to facilitating smoking with response choices ranging from "frequently" to "never", and three corresponding perceived power statements with response choices ranging from "agree" to "disagree".
Target Population: Adolescent smokers and non-smokers, ages 13-19 years.
Administrative Issues: Self-report, paper and pencil. Training for administration of instrument not described.
Scoring Information: Responses are scored on +3 to -3 bipolar scales for behavioral beliefs, outcome evaluations, normative beliefs, control beliefs, and perceived power, and unipolar scoring ranging from +1 to +7 are used for motivations to comply.
Psychometrics: Psychometric evaluation based on N=430 females from three different ethnic groups (141 African Americans, 146 Puerto Ricans, and 143 non-Hispanic Whites).

Content validity: conducted through small focus groups of 20 participants and an open-ended questionnaire administered to 80 participants to identify salient beliefs, referents, and control beliefs. Modal responses given by greater than 10% of the participants were used to develop the FAHQ items.

Internal consistency (Cronbach's Alpha):
    Smoking Attitudes Scale: alpha = 0.68 for African Americans, alpha = 0.78 for Puerto Ricans, and alpha = 0.82 for non-Hispanic Whites.
    Subjective Norm Scale: alpha = 0.68 for African Americans, alpha = 0.76 for Puerto Ricans, and alpha = 0.77 for non-Hispanic Whites.
    Perceived Behavioral Control Scale: alpha = 0.63 for African Americans, alpha = 0.54 for Puerto Ricans, and alpha = 0.45 for non-Hispanic Whites.
No test-retest reliability.

Evidence of Concurrent validity (logistic regression used to predict smoking behavior in the previous 30 days):
    Smoking Attitudes Scale: Among African Americans, the scale correctly predicted smoking behavior 94% of the time. Among Puerto Ricans, the scale correctly predicted smoking behavior 90% of the time. Among non-Hispanic Whites, the scale correctly predicted smoking behavior 96% of the time.
    Subjective Norm Scale: Among African Americans, the scale correctly predicting smoking behavior 68% of the time. Among Puerto Ricans, the scale correctly predicted smoking 71% of the time. Among non-Hispanic Whites, the scale correctly predicted smoking 71% of the time.
    Perceived Behavioral Control Scale: Among African Americans, the scale correctly predicting smoking behavior 84% of the time. Among Puerto Ricans, the scale correctly predicted smoking 81% of the time. Among non-Hispanic Whites, the scale correctly predicted smoking 85% of the time.
Clinical Utility of Instrument: The FAHQ can serve as a guide in the development of culture/population-specific smoking prevention programs.
Research Applicability: The FAHQ can be used to investigate any potential differences in smoking-related beliefs among participants of varying cultural backgrounds. This type of data can be particularly informative considering the disparate age of smoking onset among different ethnic groups.
Copyright, Cost, andSource Issues: No charge for use.
Source Reference: Hanson, M.S. (1999). Cross-cultural study of beliefs about smoking among teenaged females. Western Journal of Nursing Research, 21(5), 635-651.
Supporting References: None.
Author: Mary Jane S. Hanson, Ph.D., C.R.N.P.
Assistant Professor and Director of Graduate Program
Contact Information: University of Scranton
Department of Nursing
Scranton, PA 18510
hansonm2@UofS.edu
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Last Updated: May 1, 2012

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