Development and validation of a smoking media literacy scale for adolescents

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 (α=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. ©2006 American Medical Association. All rights reserved.