Development and validation of a new instrument to measure perceived risks associated with the use of tobacco and nicotine-containing products

Cano, Stefan and Chrea, Christelle and Salzberger, Thomas and Alfieri, Thomas and Emilien, Gerard and Mainy, Nelly and Ramazzotti, Antonio and Lüdicke, Frank and Weitkunat, Rolf (2018) Development and validation of a new instrument to measure perceived risks associated with the use of tobacco and nicotine-containing products. Health and Quality of Life Outcomes, 16 (1). pp. 192-206. ISSN 1477-7525


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Making tobacco products associated with lower risks available to smokers who would otherwise continue smoking is recognized as an important strategy towards addressing smoking-related harm. Predicting use behavior is an important major component of product risk assessment. In this context, risk perception is a possible factor driving tobacco product uptake and use. As prior to market launch real-world actual product use cannot be observed, assessing risk perception can provide predictive information. Considering the lack of suitable validated self-report instruments, the development of a new instrument was undertaken to quantify perceived risks of tobacco and nicotine-containing products by adult smokers, former smokers and never-smokers. Initial items were constructed based on a literature review, focus groups and expert opinion. Data for scale formation and assessment were obtained through two successive US-based web surveys (n=2020 and 1640 completers, respectively). Psychometric evaluation was based on Rasch Measurement Theory and Classical Test Theory. Psychometric evaluation supported the formation of an 18-item Perceived Health Risk scale and a 7-item Perceived Addiction Risk scale: item response option thresholds were ordered correctly for all items; item locations in each scale were spread out (coverage range 75-87%); scale reliability was supported by high person separation indices > 0.93, Cronbach's alpha > 0.98 and Corrected Item-Total Correlations > 0.88; and no differential item functioning was present. Construct validity evaluations met expectations through inter-scale correlations and findings from known-group comparisons. The Perceived Risk Instrument is a psychometrically robust instrument applicable for general and personal risk perception measurement, for use in different types of products (including cigarettes, nicotine replacement therapy, potential Modified Risk Tobacco Products), and for different status groups (i.e., current smokers with and without intention to quit, former smokers, never smokers).

Item Type: Article
Additional Information: This research was funded by Philip Morris Products S.A. However, the funders were not involved in the psychometric data analysis and interpretation.
Keywords: Risk perception, Modified risk tobacco products, Psychometrics, Public health
Divisions: Departments > Finance, Accounting and Statistics > Statistics and Mathematics
Version of the Document: Published
Depositing User: Gertraud Novotny
Date Deposited: 12 Dec 2018 15:10
Last Modified: 24 Aug 2020 11:18
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