Development and validation of a 21-item challenges to stopping smoking (CSS-21) scale. Issue 3 (31st March 2016)

• Record Type: Journal Article
• Authors: Thomas, Dennis; Mackinnon, Andrew J; Bonevski, Billie; Abramson, Michael J; Taylor, Simone; Poole, Susan G; Weeks, Gregory R; Dooley, Michael J; George, Johnson
• Is Part Of: BMJ open. Volume 6:Issue 3(2016)
• Publication Date: 2016-03-31
• Subjects: Smoking -- reliability -- validity -- challenges -- tool; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2016-011265
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: Identification of challenges associated with quitting and overcoming them may improve cessation outcomes. This study describes the development and initial validation of a scale for measuring challenges to stopping smoking. Methods: The item pool was generated from empirical and theoretical literature and existing scales, expert opinion and interviews with smokers and ex-smokers. The questionnaire was administered to smokers and recent quitters who participated in a hospital-based smoking cessation trial. Exploratory factor analysis was performed to identify subscales in the questionnaire. Internal consistency, validity and robustness of the subscales were evaluated. Results: Of a total of 182 participants with a mean age of 55 years (SD 12.8), 128 (70.3%) were current smokers and 54 (29.7%) ex-smokers. Factor analysis of the 21-item questionnaire resulted in a 2-factor solution representing items measuring intrinsic (9 items) and extrinsic (12 items) challenges. This structure was stable in various analyses and the 2 factors accounted for 50.7% of the total variance of the polychoric correlations between the items. Internal consistency (Cronbach's α) coefficients for the intrinsic and extrinsic subscales were 0.86 and 0.82, respectively. Compared with ex-smokers, current smokers had a higher mean score (±SD) for intrinsic (24.0±6.4 vs 20.5±7.4, p=0.002) and extrinsic subscales (22.3±7.5 vs 18.6±6.0, p=0.001). Conclusions: Initial evaluation suggests that the 21-item challenges to stopping smoking scale is a valid and reliable instrument that can be used in research and clinical settings to assess challenges to stopping smoking.