Development and validation of a smoking media literacy scale for adolescents

Abstract

Objectives: To develop a smoking media literacy (SML) scale by using empiric survey data from a large sample of high school students and to assess reliability and criterion validity of the scale.

Design: On the basis of an established theoretical framework, 120 potential items were generated, and items were eliminated or altered on the basis of input from experts and students. Cross-sectional responses to scale items, demographics, smoking-related variables, and multiple covariates were obtained to refine the scale and determine its reliability and validity.

Setting: One large Pittsburgh, Pa, high school.

Participants: A total of 1211 high school students aged 14 to 18 years.

Main outcome measures: Current smoking, susceptibility to smoking, attitudes toward smoking, and smoking norms.

Results: Factor analysis demonstrated a strong 1-factor scale with 18 items (alpha = 0.87). After controlling for all covariate data, SML had a statistically significant and independent association with current smoking (P = .01), susceptibility (P<.001), and attitudes (P<.001), but not norms (P = .42). Controlling for all covariates, an increase of 1 point on the 10-point SML scale was associated with a 22% decrease in the odds of being a smoker and a 31% decrease in the odds of being susceptible to smoking.

Conclusions: Smoking media literacy can be measured with excellent reliability and concurrent criterion validity. Given the independent association between SML and smoking, media literacy may be a promising tool for future tobacco control interventions.

Figures

Figure 1

The theory of reasoned action, applied to mass media and smoking. Media literacy interventions, which examine the manipulative construction of tobacco industry messages and the salient omissions of those messages, would be expected to decrease positive attitudes toward smoking. Media literacy would also be expected to correct misperceptions regarding the normality of smoking by (1) exposing the industry techniques used to make behaviors seem more normative and (2) emphasizing the difference between “television reality” and “real reality.”

Figure 2

Study population and response rate.