Validation of a measure of normative Beliefs about smokeless tobacco use

Sarah E. Adkison, Richard J. O'Connor, Maansi Bansal-Travers, K. Michael Cummings, Vaughan W. Rees, Dorothy K. Hatsukami

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Introduction: Validated methods to evaluate consumer responses to modified risk tobacco products (MRTPs) are needed. Guided by existing literature that demonstrates a relationship between normative beliefs and future intentions to use tobacco the current research sought to (1) develop a measure of normative beliefs about smokeless tobacco (ST) and establish the underlying factor structure, (2) evaluate the structure with confirmatory factor analysis utilizing an independent sample of youth, and (3) establish the measure's concurrent validity. Methods: Respondents (smokers and nonsmokers aged 15-65; N = 2991) completed a web-based survey that included demographic characteristics, tobacco use history and dependence, and a measure of attitudes about ST adapted from the Normative Beliefs about Smoking scale. A second sample of youth (aged 14-17; N = 305) completed a similar questionnaire. Results: Exploratory factor analysis produced the anticipated three-factor solution and accounted for nearly three-quarters of the variance in the data reflecting (1) perceived prevalence of ST use, (2) popularity of ST among successful/elite, and (3) approval of ST use by parents/peers. Confirmatory factor analysis with data from the youth sample demonstrated good model fit. Logistic regression demonstrated that the scales effectively discriminate between ST users and nonusers and are associated with interest in trying snus. Conclusions: Assessment of MRTPs for regulatory purposes, which allows messages of reduced risk, should include measurement of social norms. Furthermore, surveillance efforts that track use of new MRTPs should include measures of social norms to determine how norms change with prevalence of use.

Original languageEnglish (US)
Article numberntv136
Pages (from-to)801-808
Number of pages8
JournalNicotine and Tobacco Research
Issue number5
StatePublished - May 1 2016

Bibliographical note

Funding Information:
Funding for this research was provided by a cooperative agreement with the National Cancer Institute (U19 CA157345). The NCI did not contribute to the study design, data collection, analysis or interpretation of the data, or to composing and submitting the manuscript.

Publisher Copyright:
© The Author 2015.


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